Atypical Aortic Coarctation Complicating Takayasu’s Arteritis Presenting as Pyoderma Gangrenosum in A Young Boy: Case Report and Review of Literature
Koné Guéladio Hassane, Bounsir Ayoub, Mehssani Zineb, Srairi Jameleddine, Fellat Rokya, Lekehal Brahim, Fellat Nadia
Sch J Med Case Rep | 197-201
DOI : 10.36347/sjmcr.2021.v09i03.001
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Introduction: Atypical aortic coarctation is very rare, accounting for up to 2 % of aortic coarctation malformation. Several etiologies have been described and the most common is the Takayasu’s arteritis. Skin manifestations of TA are very rare and an association with pyoderma gangrenosum has been reported. This case highlights the diagnosis and management challenges. Case report: A 10 years old boy with pyoderma gangrenosum was admitted for hypertensive emergency. TEE and CT scan further revealed an atypical aortic coarctation complicating Takayasu arteritis. The inflammatory storm was managed with immunosuppressive therapy. Conclusion: Atypical aortic coarctation is rare. Takayasu’s disease is its main reported etiology and has poor prognosis. Early diagnosis and treatment are therefore crucial to prevent further damage to the blood vessel.
Endodontic and Periodontal Management of an Apical Fenestration: A Case Report
Ayari Ghada, Nasri Wafa, Bagga Sana, Hamdane Khaireddine, Ben Hadj Khalifa Aymen, Sahtout Souad
Sch J Med Case Rep | 202-206
DOI : 10.36347/sjmcr.2021.v09i03.002
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This study reports the case of a 52-year-old woman in good state of health (ASA) showed up with pain on biting, the gutta percha was visible through the alveolar mucosa exceeding the apex of the first upper right premolar two weeks after root canal treatment and the healing of a sinus tract. The CBCT exam revealed a buccal malposition of the tooth and the apical third of the buccal root perforated the alveolar buccal plate. The treatment rationale is presented and compared with other therapeutic options described in the literature. A root end resection in association with a bone filling from the adjacent site were performed to preserve the tooth. The evolution was favorable after surgery. The therapeutic approach gave satisfactory results.
Interest of Biodentine as Pulp-Capping Materiel under CAD/CAM Ceramic Inlay
Meriem Ben Miled, Rihab Dakhli, Mohsen Maaned, Hayet Hajjami, Mounir Cherif
Sch J Med Case Rep | 207-210
DOI : 10.36347/sjmcr.2021.v09i03.003
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Recently, tissue economy is considered as one of today’s key preoccupations. The preservation of pulp vitality falls within this context and must be attempted, especially in the case where the tooth is intended to serve as abutments of fixed restauration. For this reason, direct pulp capping, previously contraindicated under a fixed prosthesis, is now recommended and possible thanks to the recent appearance on the market of new biomaterials, in particular Biodentine. It is a bioactive cement with dentin-like mechanical properties that allows it to withstand contraction forces underneath direct or indirect restorations.
Malignant Cylindroma- A Rare Case Diagnosis Made on Cytology
Dr. Navneet Kaur, Dr. Kanwardeep Kaur, Dr. Shaffaly Gagneja, Dr. Haspreet Kaur Gill
Sch J Med Case Rep | 211-213
DOI : 10.36347/sjmcr.2021.v09i03.004
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Malignant cylindroma (cylindrocarcinoma) is an extremely rare adnexal neoplasm. Malignant cylindroma may develop via malignant transformation of long standing benign cylindroma or may develop denovo in others [1]. There are few cases of malignant transformation of dermal cylindromas in the literature [2]. Here we report a rare case of malignant cylindroma reported on cytology in a 56 year old male patient with a solitary lesion on occipital region.
Atypical Case of Conjunctival Epitheloid Hémangioma
Yassine El Ghani, Sarah Belghmaidi, Bouda Raja, Hajji Ibtissam, Abdeljalil Moutaouakil, Aarab Ayoub, Hanane Raiss
Sch J Med Case Rep | 214-215
DOI : 10.36347/sjmcr.2021.v09i03.005
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Conjunctival capillary hemangioma is an uncommon vascular tumor, we present a unique and atypical case spontaneously developed in an adolecent with allergic conjunctivitis, without associated systemic disease process or cutaneous manifestations.
Malignant Pheochromocytoma with Liver Metastases: About A Case
Mounir Jamali, Othmane El Houadfi, Omar El Jendouzi , Ahmed Ameur, Mohamed Alami, Reda Tariqi
Sch J Med Case Rep | 216-220
DOI : 10.36347/sjmcr.2021.v09i03.006
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Pheochromocytomas are rare tumors, developed at the expense of the adrenal medulla and paraganglia. The excess of catecholamines secreted leads to clinical symptomatology. The diagnosis of malignancy is made only by the presence of metastases from organs devoid of chromaffin tissue or by the appearance of neoplastic recurrences. A 20-year-old woman was reported to have hypertensive crises with cerebral and ocular repercussions. A malignant pheochromocytoma of the left adrenal gland with hepatic metastases was diagnosed and the patient underwent left adrenalectomy with hepatic metastasectomy and surgical portal embolization in preparation for a subsequent right hepatectomy.
Synovial Sarcoma with Neuronal Differentiation- A Case Report
Dr. Balaji S, Dr. Jonathan Arnold, Dr. Govindaraj T, Dr. Muthukumar
Sch J Med Case Rep | 221-226
DOI : 10.36347/sjmcr.2021.v09i03.007
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Synovial sarcomas are malignant, high-grade, soft-tissue neoplasms that are estimated to represent between 5% and 10% of all soft-tissue sarcomas. In fact, in adults, synovial sarcoma is the fourth most common type of sarcoma after malignant fibrous histiocytoma, liposarcoma and rhabdomyosarcoma. It predominantly affect the extremities but can occur in any part of the body, including the head and neck. This tumor is most prevalent in adolescents and adults between 15 and 40 years of age. Concerning gender incidence, the male: female ratio is 1.2:1, with males being more frequently affected. Synovial sarcomas not only are locally aggressive but also have a higher metastatic potential than most other soft-tissue sarcomas. Hence, the overall prognosis for synovial sarcoma patients is poor. We reported a case of synovial sarcoma with neuronal differentiation located on the dorsal aspect of the right foot of an 38 years old male. This case illustrates the neuronal differentiation of the tumor which could have been misdiagnosed as neuronal tumor in FNAC and the challenges to differentiate it from other biphasic tumors. Thorough HPE examination and immunohistochemistry are mandatory for early diagnosis and to avoid misdiagnosis.
Original Research Article
March 10, 2021
Double Puncture-Aspiration-Injection-Reaspiration (dPAIR) in Hydatid Cysts Management: Report of 10 Cases
S. Bellasri, B. Slioui, R. Akka, H. Baba, M. Sbai, N. Hammoune, A. Mouhsine, E. Atmane
Sch J Med Case Rep | 227-230
DOI : 10.36347/sjmcr.2021.v09i03.008
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Introduction: Hydatid cyst is endemic parasitic zoonosis in North Africa, caused by Echinococcus granulosus. The cysts commonly developed in liver. Classically the treatment is based on association of open surgery and oral chemotherapy, but since the mid 1980s a minimally invasive procedure was proposed by a Tunisian team, called PAIR (Puncture, Aspiration, Injection, Re-aspiration). This technique proved its efficacy and safety management of active hydatid cysts. Aims and scope: We report a reinforced variant of this procedure with double aspiration, injection and re-aspiration using initially hypertonic saline serum and secondary absolute alcohol 96%. Material and methods: A retrospective study conducted on 8 patients (10 liver hydatid cysts) collected from the department of interventional radiology between jan-2016 to decem-2020. An 18 needle puncture after local anaesthesia and under sonographic guidance, aspiration of the cyst and subsequent injection aspiration of two protoscolicidal agent: hypertonic saline serum first and then absolute alcohol 96%. Results: All cases were successfully treated, with short hospitalization length. There was no major complication or morbidity. Conclusions: Obviously, this second aspiration-injection, re-aspiration increase efficacy and decrease recurrence probability.
Percutaneous Drainage of Splenic Tubercular Abscess: Assessment of Effectiveness and Safety
S. Bellasri, B. Slioui, N. Hamoune, H. Baba, A. Raissi, M. Miloudi, A. Mouhsine, E. Atmane
Sch J Med Case Rep | 231-233
DOI : 10.36347/sjmcr.2021.v09i03.009
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Splenic tubercular abscess is a rare pathologic conditionand mainly affects immunocompromised individuals. Open surgery and antituberculous drugs was the treatment of choice. Mini invasive procedures such us percutaneous catheter drainage is currently an effective and safe alternative to splenectomy. We present a case of a 24-year-old man with recently diagnosis of Hodgkin’s lymphoma with good socioeconomic background, who endured fever and left upper abdominal pain; however, computed tomography scan for extension of Hodgkin’s lymphoma revealed a large splenic collection with thick rim interpreted as abscess. Percutaneous drainage of the abscess was performed by interventional radiology. Diagnosis of mycobacterium tuberculosis was confirmed by rapid molecular detection using automated GeneXpert MTB. Our case highlights the following: (a) The importance of minimal invasive procedure in health care system, that reduces length hospitalization, surgical complication and increase cost-effectiveness; (b) The safety of percutaneous drainage even in spleen which may scare radiologist.
Pseudocyesis and a Maternity Delirium: A Case Report
Maryam Abrache, Sara Ennazk, Imane Adali, Fatiha Manoudi
Sch J Med Case Rep | 234-235
DOI : 10.36347/sjmcr.2021.v09i03.010
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The definition of pseudocyesis consists of the delusional conviction of being pregnant accompanied by objective signs and symptoms of pregnancy despite a negative paraclinical assessment mainly comprising the BHCG assay. We report here the case of a patient who presented a maternity delirium following pseudocyesis, discussing this case in the light of the literature.
Managing the Complications of Cirrhosis during COVID-19 Pandemic: Review of the Literature and a Case Study
H.Elabbassi, K. Krati, H. Aouroud, Oubaha S, Samlani Z
Sch J Med Case Rep | 236-240
DOI : 10.36347/sjmcr.2021.v09i03.011
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The COVID-19 pandemic has spread rapidly through the world and the care system should adapt rapidly to this context. In our case, managing cirrhosis and its complications during this pandemic situation is one of the main challenges we are facing actually. For this reason, we report in this article the case of a patient admitted in compensation for his cirrhosis and diagnosed positive COVID -19. First, we explained the adopted protocol. Then, we reviewed the main protocols proposed for similar cases in the literature.
Paraneoplastic Acral Vascular Syndrome Due to Pulmonary Adenocarcinoma: Case Report
Jaouad Yousfi, Soukaina Oumlil, Mouna Zahlane, Lamiaa Essaadouni
Sch J Med Case Rep | 241-242
DOI : 10.36347/sjmcr.2021.v09i03.012
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Acral vascular syndrome is the translation of a general or locoregional pathology. It is associated with atherosclerotic, thromboembolic, or connective tissue diseases. Less often, it can be related to malignancy. However, the etiological assessmentshould not delay the treatment in order to preserve functional prognosis. We present the case of a patient with paraneoplastic acral vascular syndrome as an initial manifestation of lung cancer. In the absence of an identifiable iatrogenic cause, occupational diseases, atherosclerosis or systemic disease, digital necrosis should alert the examiner to search for a neoplastic etiology namely a solid cancer or haemopathy.
Simultaneous "Bucket-Handle" Tear of Both Menisci on the Same Knee
M. Ouali idrissi, Jaafari F, Zouine Y, Boutakiout B, Cherif idrissi guennouni N
Sch J Med Case Rep | 243-245
DOI : 10.36347/sjmcr.2021.v09i03.013
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About 10% of meniscal tears are bucket-handle tears and more frequently affect the medial meniscus three times more than the external meniscus. It turns out that the simultaneous tear in à bucket handle at the same knee is a rare phenomenon. In this article we report a case of a 25-year-old man with a simultaneous bucket-handle tear in the same knee discovered on magnetic resonance imaging. Magnetic resonance imaging provides an accurate diagnosis of this type of injury.
Case of Acute Ataxia and behavioral disturbances as the only Signs of Abdominal Neuroblastoma
F. Jaafari, B. Bannar, I. Zouita, D. Basraoui, H. Jalal
Sch J Med Case Rep | 246-248
DOI : 10.36347/sjmcr.2021.v09i03.014
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Childhood presentations of ataxia, an impairment of balance and coordination caused by damage to or dysfunction of the cerebellum, can often be challenging to diagnose. Ataxia alone is rare as a paraneoplastic sign, especially if it is due to neuroblastoma (abdominal or chest). Although the pathogenesis is not known, the association of these entities shows similarity to the adult association of cerebellar ataxia with occult neoplasms. Chest and abdominal imaging may aid in diagnosing otherwise silent and occult neuroblastoma and is recommended when cerebellar ataxia is present. We report an abdominal neuroblastoma in a one and half year-old boy presenting with only acute ataxia, behavioral disturbances and abnormal neuroimaging. Brain MRI showed abnormal signal finding in the occipital subcortical white matter and the periventricular space. In the abdominal CT, a mass was detected in the left adrenal gland. We suggest in children with acute ataxia, with or without opsoclonus-myoclonus, neuroblastoma should be considered.
Psoriatic Rheumatism at ACPA Positive: About a Case Review of the Literature
Cédric Régis Boumba Makaya, Imane El Bouchti
Sch J Med Case Rep | 249-251
DOI : 10.36347/sjmcr.2021.v09i03.015
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Some clinical presentations of psoriatic rheumatism are similar to those of rheumatoid arthritis. We report the case of a patient aged 72 years, asthmatic for 40 years, ethyl and chronic smoking who was admitted for chronic arthritis. Clinical examination objectified, peripheral joint syndrome, deformities of the hands and feet. The assessment objectified a biological inflammatory syndrome, a CRP at 69mg/L; Rheumatoid factor at 678 IU and ACPA at 191 IU. The radiological assessment revealed a structural impairment with an aspect of periostitis in juxta-articular spicule, periosteal affixing; with an aspect of «pencil in cup». The diagnosis of psoriatic rheumatism with ACPA positive was retained in this patient. This patient was offered a weekly treatment with etanercep (Enbrel) 50mg subcutaneously. The pencil in cup and spicule aspects were the most important radiographic feature to distinguish psoriatic rheumatism from immunopositive rheumatoid arthritis. This clinical case has shown the usefulness of simple x-rays for the diagnosis of psoriatic rheumatism.
Giant Cell Tumor: Cyst of the Intercondylar Fossa of the Knee (A Reported Case)
H. Filali Baba, M. Lahsika, D. Oudrhiri, H. Abid, M. El Idrissi, A. El Ibrahimi, A. Elmrini
Sch J Med Case Rep | 252-255
DOI : 10.36347/sjmcr.2021.v09i03.016
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Giant cell tumors of the synovial sheaths (GCTSS), or tenosynovial giant cell tumor, or hemopigmented villonodular synovitis, develop from the articular and periarticular synovium. LVPS may be clinically indistinguishable from meniscal injury or other internal disturbance. This lesion is histologically identical to its diffuse counterpart but has a different behavior and response to treatment. MRI usually reveals a variable-sized of nodule with a decreasing heterogeneous signal on T1-weighted and T2-weighted images.In arthroscopy; there is a slightly Giant cell tumors of the synovial sheaths (GCTSS), or tenosynovial giant cell tumor, or hemopigmented villonodular synovitis, develop from the articular and periarticular synovium. LVPS may be clinically indistinguishable from meniscal injury or other internal disturbance. This lesion is histologically identical to its diffuse counterpart but has a different behavior and response to treatment. MRI usually reveals a variable-sized of nodule with a decreasing heterogeneous signal on T1-weighted and T2-weighted images.In arthroscopy; there is a slightly pigmented synovial mass; with punctate purpura if the tourniquet is swollen, in the absence of other lesions should alert the surgeon of the diagnosis. The treatment consists of a wide-marginal arthroscopic resection, the prognosis of which is excellent if it is complete.pigmented synovial mass; with punctate purpura if the tourniquet is swollen, in the absence of other lesions should alert the surgeon of the diagnosis. The treatment consists of a wide-marginal arthroscopic resection, the prognosis of which is excellent if it is complete.
Original Research Article
March 17, 2021
The Chest CT Scanner in the Diagnosis of COVID 19 Infection, Experience of Radiology Department of University Hospital of Marrakech, Morocco
F. Jaafari, M. Ouali Idrissi, B. Bannar, B. Boutakioute, N. Cherif Idrissi Ganouni
Sch J Med Case Rep | 256-260
DOI : 10.36347/sjmcr.2021.v09i03.017
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Introduction: To optimize patient management, medical care and pandemic control, it is important to determine the effectiveness of chest CT scan to distinguish COVID-19 from other types of pneumonia. The objective of our work is to present the contribution of the chest CT scan in the diagnosis of Covid-19 viral infection. Material and method: This is a prospective study carried out from 20 March 2020 to 31 May 2020, of 444 cases identified in the radiology department of university hospital of Marrakech, concerning all patients with a clinical suspicion of coronavirus infection. Results: The average age of our patients was 52 years, with extremes ranging from 15 to 93 years, a sex H/F ratio of 1.41. Hypertension, diabetes and smoking were the most common co-morbidities. The most common clinical signs were cough, dyspnea and fever. The radiological signs most frequently found were the peripheral ground glass opacification of the posterior regions, followed by consolidations, less frequently the crazy paving, halo sign and reverse halo sign, 2 cases of unilateral form versus 119 cases of bilateral form. The percentage reached was as follows: Minimal (<10%): 37 cases, Moderate (10-25%): 25 cases, Extensive (25-50%): 24 cases, Severe (50-75%): 15 cases, Critical (>75%): 5 cases. The differential diagnosis mainly found were bronchopneumonia, exacerbations of bronchiectasis, cardiac decompensations and tuberculosis. The scanner-PCR correlation was as follows: PCR - / CT -: 106 cases, PCR + / CT +: 72 cases, PCR -/ CT +: 30 cases, PCR + / CT-: 16 cases, CT - / PCR not done: 198 cases, CT + / PCR not done: 19 cases. Conclusion: The scanner has had a central role in the management of patients with respiratory symptoms in this pandemic. This review also assessed the severity of lung disease, monitored disease progression based on worsening lesions, and participated in the patient referral decision (COVID vs Non-COVID unit) anticipating PCR data.
Report Case: Alveolar Microlithiasis
F. Jaafari, B. Bannar, B. Boutakioute, M. Ouali Idrissi, N. Cherif Idrissi Ganouni
Sch J Med Case Rep | 261-264
DOI : 10.36347/sjmcr.2021.v09i03.018
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Alveolar microlithiasis (AMP) is a rare genetic disease characterized by intra-alevolar phosphate and calcim deposition in the pulmonary parenchyma in a sparse bilateral manner with a predominance in the lower and middle regions. This disease results from a genetic dysfunction characterized by inactivating mutations in the SLC34A2 gene resulting in local intra-alveolar phosphate aggregation due to sodium-dependent phosphate co-transporter deficiency. Patients with this disease are usually seen in late stages with a chronic pulmonary heart and hypoxemia. High resolution chest CT scan with chest x-ray make it possible to diagnose this disease with a pathognomonic appearance in the form of diffuse calcified micronodules. Only lung transplantation has been shown to be effective as a treatment for the disease. We describe the case of a 58-year-old woman with a history of pulmonary tuberculosis treated in 1994 and siblings treated for undocumented pneumonia, referred to our department for a chest scan and presenting with NYHA stage III dyspnea and greenish sputum. Imaging was suggestive of extensive bilateral interstitial lung disease.
Pulmonary Venous Varix: A Typical Diagnosis in Imaging
F. Jaafari, B. Bannar, B. Boutakioute, M. Ouali Idrissi, N. Cherif Idrissi Ganouni
Sch J Med Case Rep | 265-268
DOI : 10.36347/sjmcr.2021.v09i03.019
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Pulmonary venous varix is a rare focal involvement of a pulmonary vein that becomes dilated. Pulmonary varices are congenital or acquired following distal venous occlusion by a pathology affecting the mitral valve or hepatic cirrhosis. On the chest x-ray, pulmonary varicose veins may be unnoticed or present as a solitary lung nodule next to the left atrium.On chest computed tomography, they take on the appearance of serpeginous vascular structures with no nidus image and no connection with arterial structures frequently found in AVM. Pulmonary varices are asymptomatic with a stable course, requiring no treatment except complications.
Original Research Article
March 18, 2021
Quality of Life in Chronic Hemodialysis Patients
Labrassi M, Fadili W, Oussaih L, Chettati M, Laouad I
Sch J Med Case Rep | 269-273
DOI : 10.36347/sjmcr.2021.v09i03.020
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Background and objectives: This study was conducted to measure the level of health-related quality of life (HRQOL) and to determine the variables associated with poor scores. Methods: Cross-sectional cohort of 100 maintenance hemodialysis patients in the Marrakesh area. Quality of life was assessed through the KDQOL SF-36 tool. Univariate and multivariate analyses were performed to determine the variables associated with the quality of life scores. Results: The mean scores obtained in the KDQOL-SF 36 were 39,77±10,41 for physical component summary (PCS) ; 45,01±13,11 for mental component summary (MCS) ; 46,91±26,69 for symptoms and problems score ; 52,7±28,76 for burden of kidney disease score and 63,86±29,61 for effects of kidney disease on daily life score. PCS score was independently associated with age of 60 years or more (OR=6,294 [1,281-30,919], p=0,024) and educational level (OR=0,328 [0,124-0,869], p=0,025). Conclusion: Many factors impact quality of life of hemodialysis patients. Effective assessment of HRQOL allows adequate interventions to improve patient satisfaction and to reduce morbidity and mortality.
Fetal Rescue in Fatal Evolution of a Pregnant Woman with COVID-19: A Case Report
H. Asmouki, A. Jamal Eddine, K. Elbehja, A. Soumani, A. Ziadi, F. Douirek, M. Rhezali, Y. Zarouki, AR. El Adib, MA. Samkaoui
Sch J Med Case Rep | 274-276
DOI : 10.36347/sjmcr.2021.v09i03.021
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A pregnant woman (Gravida 5, Abortion 1, Gestational Age: 35 weeks) was referred to our tertiary referral hospital with complaints of asthenia, dry cough and dyspnea. She had pulse rate of 77, respiratory rate of 50, with oral temperature of 38.5, O2 sat: 83% in room air. Her chest CT on admission had bilateral patchy ground-glass features, nasopharyngeal swab for SARS-CoV-2 had a positive result. She was admitted with a diagnosis of COVID-19. And antepartum fetal monitoring was reassuring. During her hospitalization, O2 saturation progressively declined, which required a transfer to the ICU and acute respiratory care and support, leading to intubation and mechanical ventilation. With concerns for fetal well-being she underwent a cesarean delivery of a viable but premature neonate. With persistent postpartum ARDS (SaO2 20%-30% on maximal ventilator support) she experienced acute hypotension and bradycardia 3 hours later and died despite cardiopulmonary resuscitative efforts.
Isoniazid Induced Psychosis: A Case Report
Dr. Natraj M, Dr. Gulnar Begum, Dr. S. P. Burma
Sch J Med Case Rep | 277-278
DOI : 10.36347/sjmcr.2021.v09i03.022
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Isoniazid is a first line drug used in the treatment of tuberculosis. Psychosis is a state of altered mentation and behavior. Although psychosis is known complication of isoniazid therapy, type and onset of symptoms is highly variable. Here we report a case of 44 years old female who developed psychosis characterized by irrelevant talks, agitation, and echolia after four days of starting ATT.
Darier’s Disease – A Case Report
S. Srikanth, J. Rajitha
Sch J Med Case Rep | 279-280
DOI : 10.36347/sjmcr.2021.v09i03.023
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Darier’s disease or keratosis follicularis is a rare autosomal dominant genodermatosis, which is characterized by greasy, crusted, keratotic, yellow brown warty papules and plaques particularly over seborrhoeic areas. Darier disease is a skin condition characterized by wart-like blemishes on the body. The blemishes are usually yellowish in color, hard to the touch, mildly greasy, and can emit a strong odor. The most common sites for blemishes are the scalp, forehead, upper arms, chest, back, knees, elbows, and behind the ear. Although this is a genetically transmitted disease according to a larger series, about 47% of patients had no clear family history, presumably because of incomplete penetrance. The prevalence of this disorder in population is 1: 100,000. The sex incidence is equal, although the males appear to be more severely affected than females. The oral mucosa is affected in 50% of the cases, and lesions are usually asymptomatic and discovered during routine dental examination. Lesions are represented by multiple firm papules with normal, whitish, or reddish color, primarily affecting the palatal and alveolar mucosa.
Myxolipoma in the Neck - A Case Report with Review of Literature
Shaina Goyal, Monika Garg, Anita Chaudhary, Monika Kalyan, Nazma
Sch J Med Case Rep | 281-283
DOI : 10.36347/sjmcr.2021.v09i03.024
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Myxolipoma is an uncommon type of mesenchymal tumor. It is a lipoma admixed with abundant mucoid substances and is considered to be a lipoma with a high degree of myxoid change. We present a rare case of a benign mesenchymal tumor with a lipomatous and myxoid component. An 86 year old male patient presented with the chief complaint of swelling on the left side of the neck. Ultrasonography of the swelling was indicative of cystic swelling with benign etiology. Magnetic Resonance Imaging revealed a well-defined complex lobulated lesion along the anterior and the superior aspect of the left sternoclavicular joint in the subcutaneous plane. Aspiration cytology was suggestive of a mesenchymal tumor. Thereafter the swelling was excised and histological examination revealed features of myxolipoma. The postoperative course was uneventful with no evidence of recurrence two years after the surgery.
Lane’s Tumor of Maxilla- A Case Report and Review of Literature
Dr. Ekta Rani, Dr. Sarita Nibhoria, Dr. Navjot Kaur, Dr. Shilpa Pal
Sch J Med Case Rep | 284-287
DOI : 10.36347/sjmcr.2021.v09i03.025
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Lane’s Tumor also known as Sarcomatoid squamous cell carcinoma (SSCC) or spindle cell carcinoma is a rare and peculiar biphasic malignant neoplasm that occurs mainly in the upper aerodigestive tract. It is a variant of squamous cell carcinoma which has spindled or pleomorphic tumor cells which simulate a true sarcoma, but are epithelial in origin. Spindle cell neoplasms are very uncommon in the oral cavity, accounting for <1% of all tumors of oral region. It is an unusual aggressive variant that frequently recurs and metastasizes, reinforcing the importance of its correct diagnosis. We report a immunohistochemicaly proven case of Lane’s tumor in 43yrs old male.
Congenital Epulis: About Four Cases in Newborns
Aiat Allah Skiredj, Nawfal Fejjal
Sch J Med Case Rep | 288-291
DOI : 10.36347/sjmcr.2021.v09i03.026
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Congenital epulis or Congenital granular cell epulis (CGCE) is a rare benign tumour in the neonate. It arises from the gingival mucosa. The most affected oral site is located around the canine/incisor region of the maxillary alveolar ridge This benign condition can be life threatening when it is obstructive. It has predominance for females. CGCE’s histogenesis remains obscure and controversial. We report 4 cases of newborns females and one male with features of obstructive congenital epulis arising from both maxillary and mandibular alveolar ridge, interfering with breast-feeding. Diagnosis was suspected clinically and confirmed by histology and immunohistochemical. Outcome was good after prompt surgery for the 3 cases. 2 of patient showed satisfactory postoperative healing and excellent health at both the 10-day recall appointment follow-up but one of them was lost to follow up.
Clear Cell Sarcoma of Soft Tissue: A Rare Malignancy Entity
Kenza Kandri Rody, Soumia Faras, Najat Elaattoul, Imane Boujguenna , Hanane Rais, Ouafa Hocar, Said Amal
Sch J Med Case Rep | 292-294
DOI : 10.36347/sjmcr.2021.v09i03.027
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Clear cell sarcoma (CCS) of soft tissue or soft tissue melanoma is a rare malignant tumor in young adults, preferentially affecting the lower limbs. We report a new observation of a 17-year-old patient, without a significant history, consulted for a nodular lesion of the left ankle, painless, appeared 06 months before, evolving in a context of general impairment. The clinical examination found a purplish nodule, about 2/2 cm, hard, fixed, associated with multiple nodular lesions along the homolateral lower limb, with the presence of homolateral inguinal lymphadenopathy. There was no associated motor or vascular disorder. The nodule ultrasound showed a mass of soft tissue, hypoechogenic, heterogeneous. The computed tomography of the ankle revealed a lesional process of the medial face infiltrating the tendon and ligament structures and encompassing the posterior tibial artery. Histological examination showed round cell malignant tumor proliferation. The immuno-histochemical supplement showed an expression of the S100 protein and monoclonal antibody HMB-45 by tumor cells. The biopsy of an inguinal node affirmed its metastatic nature. The anatomo-clinical confrontation allowed to retain the diagnosis of clear cell sarcoma. The extension assessment made of a chest-abdominal-pelvic computed tomography showed metastatic lymph nodes intra and retroperitoneal. The patient was given chemotherapy (ifosfamide-adriamycin). Sarcoma with clear soft tissue cells or melanoma of the soft parts is a rare malignant tumor. It occurs most often in young adults at the lower limbs. It is a firm subcutaneous mass, slowly progressive, well limited, usually deep attached to tendon and aponeurotic structures. The positive diagnosis is based on histology coupled with immunohistochemistry. It can be helped by molecular biology in case of doubt diagnosis with melanoma. Its poor prognosis requires early and adequate management.
Original Research Article
March 30, 2021
Unusual Craniocerebral Wounds by Penetrating Objects of Low Kinetic Energy: 3 Case Reports and a Review of Literature
Benantar L, Assamadi M, Ksiks O, Ait M’barek Y, Aniba K
Sch J Med Case Rep | 295-298
DOI : 10.36347/sjmcr.2021.v09i03.028
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Introduction: Craniocerebral wounds are open head injuries that can lead the brain parenchyma to communicate with the external environment. Penetrating objects of low kinetic energy are a rare cause of this type of lesions. This article is a presentation of 3 case studies of head trauma by penetrating objects seen in the department of neurosurgery of Ibn Tofail Hospital, Mohamed VI University Hospital Center of Marrakesh. Results: We report the cases of 3 patients admitted with a penetrating head trauma (craniocerebral wounds): two by knife following an assault and one by a metal bar due to a work-related incident. Our patients were conscious with Glasgow coma scale (GCS) of 15/15 in 2 patients and a score of 14/15 in 1 patient. A CT-scan of the head and a skull X-ray were performed for all 3 patients. The therapeutic management included a medical and surgical component (craniectomy, reconstruction of the dura mater and the skin). The evolution was favorable in all 3 cases. Conclusion: Craniocerebral wounds by penetrating objects are rare, but remain frequent in third world countries. A GCS of 8 or less is an indicator of poor prognosis. Infections and seizures are the most common complications. Despite their often spectacular appearance, these traumas are not always life-threatening.
Spontaneously Resolved Hepatic Artery Aneurysm Complicating A Laparoscopic Cholecystectomy
Y. El Badri, F. Adjimabou, B.Boutakioute, M. Ouali Idrissi, N. Cherif Idrissi Ganouni
Sch J Med Case Rep | 299-302
DOI : 10.36347/sjmcr.2021.v09i03.029
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Vascular complications following a laparoscopic cholecystectomy are less common but more serious with higher morbidity than bile duct damages. We report the case of a 79-year-old female who presented 20 days after laparoscopic cholecystectomy hepatic colic, jaundice and hematemesis. The ultrasound - Doppler / and abdominal CT angiography showed a pseudoaneurysm of the right hepatic artery compressing the bile ducts causing a dilation upstream. The evolution was marked by the spontaneous resolution of the clinical signs with complete resolution of the pseudoaneurysme in the angiography performed 48 hours later.
Gayet-Wernicke Encephalopathy: 2 Case Reports
Y. EL Badri, S Agharas, S. Alj, M. Ouali Idrissi, N. Cherif Idrissi Ganouni, H. Rebahi
Sch J Med Case Rep | 303-306
DOI : 10.36347/sjmcr.2021.v09i03.030
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Gayet-Wernicke encephalopathy is an acute neurological complication due to thiamine deficiency. The diagnosis can be difficult to make since the clinical forms can be poor or atypical. Although it is often associated with chronic alcoholism, it can also occur in all the conditions that lead to thiamine deficiency: undernutrition, chronic vomiting, prolonged fasting, and exclusive artificial feeding. It is a rare complication, reversible if is promptly treated. We report two cases of Gayet-Wernicke encephalopathy, the first occurred in a pregnant patient suffering from uncontrollable vomiting and the second patient treated with methotrexate for rheumatoid arthritis with a chronic uncontrollable vomiting due to digestive intolerance to Methotrexate (only cause found).
Encephalopathy/Encephalitis with a Reversible Splenial of the Corpus Callosum Due to the Influenza a Virus: A Case Report
Y. EL Badri, D. Basraoui, H. Jalal
Sch J Med Case Rep | 307-310
DOI : 10.36347/sjmcr.2021.v09i03.031
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The encephalopathy/encephalitis syndrome with reversible lesion of the splenium of the corpus callosum (MERS) is a clinical-radiological syndrome, associating encephalopathy and a specific radiological image. This syndrome is more frequently described in the Asian population and has been associated with certain viral and bacterial infections, including influenza. In this case, patients usually present general symptoms before the onset of neurological symptoms. We report the case of a 06-year-old child who presented a flu-like syndrome associated with dysarthria and ataxia then a disorder of consciousness. The cerebral CT scan showed a hypodensity of the splenium of the corpus callosum and the cerebral MRI showed an increased diffusion with restriction of the ADC of the same region. The influenza A virus was isolated in the nasopharyngeal swab. The neurological symptoms of MERS can be highly variable, mainly in the paediatric population. Clinicians should be aware of this disorder and include it in the differential diagnosis of encephalopathic patients, especially during the flu season. The prognosis is generally good with complete neurological and radiological resolution within few days or weeks, as observed in our patient.
Renal Teratoma: A Rare Pediatric Tumor
El Badri Y, Gakosso C, Basraoui D, Jalal H
Sch J Med Case Rep | 311-313
DOI : 10.36347/sjmcr.2021.v09i03.032
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Intra renal teratoma is an extremely rare tumor. Only few cases have been published in the literature. In its renal location, the diagnosis of teratoma is rarely mentioned preoperatively since its clinical and radiological signs are not very specific, the final diagnosis is often confirmed by the pathological study. We report the case of a cystic intra renal teratoma in a three-month-old infant who underwent an enlarged nephrectomy with pathologic confirmation of the diagnosis. Surgery is the treatment of choice for intrarenal teratoma. It is usually not sensitive to chemotherapy, so this diagnosis should always be borne in mind in front of a cystic kidney mass in order to avoid chemotherapy that is harmful to these young patients.
Eosinophilic Dermatosis of Hematologic Disease: A Case Report
Najat Elaattoul, Ayman Ismail, Anas Fakhri, Hanane Rais, Ouafa Hocar, Said Amal
Sch J Med Case Rep | 314-316
DOI : 10.36347/sjmcr.2021.v09i03.033
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Eosinophilic dermatosis of hematologic disease (EDH) or insect bite-like reaction is a rare paraneoplastic manifestation mostly described in patients with chronic lymphocytic leukemia. We report a case of a 67-years-old female patient presented to our dermatology department with a recurrent itchy papulo-vesicular lesions located on her face and extremities accompanied with asthenia and weight loss revealing chronic lymphocytic leukaemia. Based on clinical history and histopathologic features, we concluded to the diagnosis of EDH, and the patient received topical corticosteroids and antihistamines in association to chemotherapy achieving an hematological remission. However, the skin lesions recurred. The interest of this report lies in the rarity of this entity and the difficulty of differential diagnosis with lympho-proliferations. In addition, we aim to stress the fact that EDH can reveal the diagnosis of the hematologic malignancy.
