Parasitic Leiomyoma- Peritoneum- A Rare Case
Dr. Purva V Reelkar, Dr. Vijay V Reelkar
Sch J Med Case Rep | 317-319
DOI : 10.36347/sjmcr.2021.v09i04.001
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When uterine fibroid occurs in its usual site, presentation, diagnosis and management are straightforward. When it exists in unusual area, the diagnosis becomes challenging. Parasitic leiomyoma is an extremely rare disease. Their unusual growth pattern may even mimic malignancy and can result in clinical dilemma. A 42 years old female with complaints of lump in abdomen since 4 years and amenorhoea since 3 months, was having USG and CT scan findings consistent with heterogenous mass arising from uterus. Intraoperatively, peritoneal soft tissue tumour was found and HPE confirmed the diagnosis of parasitic leiomyoma.
Nasal Chondromesenchymal Hamartoma- A Rare Case Report
Kishori Dhulipala, Agastyaraju D Anuradha, Chalam P Kumuda
Sch J Med Case Rep | 320-322
DOI : 10.36347/sjmcr.2021.v09i04.002
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Nasal hamartomas are very rare lesions occurring in the early childhood.We present a case of an eight year old female patient with nasal blockade and facial deformity, with . radiological suspicion of a soft tissue density lesion in right nasal cavity and right Ethmoid and frontal sinuses. Histopathology revealed a rare benign hamartoma - Nasal Chondromesenchymal hamartoma.
Malignant Granular Cell Tumor of the Mandible: A Case Report and Review of Literature
Ngoua Essininguele Marie Lysette, Aziz Zakaria, Kabbaj Houda, Fawzi Saad, Karbouch Jinane, Mansouri Hattab Nadia
Sch J Med Case Rep | 323-325
DOI : 10.36347/sjmcr.2021.v09i04.003
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The granular cell tumor, also known as Abrikossoff's tumor, is a rare entity. It was first described by Abrikossoff in 1926. It is a ubiquitous site tumor with a predilection for the cervico-facial region. Their pathogenesis has long been debated. After initially proposing a striated muscle origin, recent studies are in favor of a Schwannian neurogenic origin. Malignant forms have been reported in the literature, with mainly lymph node and pulmonary metastases. We report a case of a malignant granular cell tumor of mandibular localization.
Acute Drug Pancreatitis: Azathioprine and Colchicine; About 2 Cases and Review of the Literature
S. Bouchrit, Y. Lemfadli, A. Ait Errami, S. Oubaha, Z. Samlani, K. Krati
Sch J Med Case Rep | 326-328
DOI : 10.36347/sjmcr.2021.v09i04.004
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Drug pancreatitis represented 0.1 to 2% of acute pancreatitis with more than 260 drugs implicated. The clinical and biological signs are not specific, the diagnosis is sometimes difficult based on the elimination of other causes of acute pancreatitis and the identification of the drug in question, the evolution is generally favorable after stopping the responsible drug. We report 2 cases of drug pancreatitis secondary to Azathioprine and colchicine.
Cesarean Scar Pregnancy
Fouzia El Hilali, Nisrine Mamouni, Majda Bendahhou Idrissi, Mohamed Karam Saoud, Sanaa Errarhay, Chahrazed Bouchikhi, Abdelaziz Banani
Sch J Med Case Rep | 329-331
DOI : 10.36347/sjmcr.2021.v09i04.005
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Cesarean scar pregnancy is a rare form of ectopic pregnancy that is life-threatening due to massive hemorrhage or uterine rupture. Earlier transvaginal ultrasound of any pregnancy with a scarred uterus makes the diagnosis and avoids the complications. There is no consensus on the management of this ectopic pregnancy, an individualized therapy must be performed according to clinical and biological features, and the surgeon’s expérience. We report a case of a 43 years old patient, with double scarring uterus, presented on emergency for vaginal bleeding. Transvaginal ultrasound showed a cesarean scar pregnancy. Laparotomy was performed, and on exploration: presence of a bulge at the isthmic level without defect or periferal vascularization. A small incision was made, the pregnancy was removed with lavage and suture of the uterine cavity.
Postpartum Early Rupture Interstitial Ectopic Pregnancy: A Life Threatened Event Due to Delayed Diagnosis. (Case Report)
Dr. Muad Gamil M Haidar, Nuha Ahmed H. Sharaf
Sch J Med Case Rep | 332-335
DOI : 10.36347/sjmcr.2021.v09i04.006
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Background: Ectopic pregnancy (EP) is a common and potentially life- and fertility-threatening condition in early pregnancy. The majority of EP are tubal. Interstitial EP is a rare site of implantation and usually associated with the highest risk of massive and uncontrollable bleeding. Despite the accurate and different diagnostic methods, the correct diagnosis of interstitial EP considered very difficult in early stages. Case Presentation: 20- year old fully lactating female gravida 2 para 1 with a history of normal vaginal delivery and amenorrhea for 5 months, presented with sudden acute abdominal pain 2 days prior to admission. On examination she had pallor tachycardic febrile and hypotensive. Her abdomen was distended and tender. She had a β-human chorionic gonadotropin level of 70 µIU/ml. The abdominal ultrasound showed only a moderate intra-abdominal collection. Emergency laparoscopic intervention revealed a large hemoperitoneum, and bleeding from a ruptured left interstitial ectopic pregnancy. The procedure was accomplished by hand-assisted suturing of the defect to control the bleeding. The patient was discharged after two days in good condition. Discussion: Early rupture of interstitial ectopic pregnancy is rare and seldom reported. Its diagnosis and management are challenging and requires prompt intervention. Although the diagnosis of ectopic pregnancy was valued in our evaluation, the exact diagnosis was unclear because the patient came in an acute abdomen, the fear of viscus perforation was existed, and the possibility of getting pregnancy in postpartum period was unexpected. Conclusion: Ruptured interstitial EP is a life threatened entity. The diagnosis of early ruptured interstitial EP is challenging in an emergency sitting. The final diagnosis usually confirmed during laparoscopic or surgical intervention.
Mediastinitis Complicating Odontogenic Cervicofacial Cellulitis
Ngoua Essininguele Marie Lysette, Kabbaj Houda, Aziz Zakaria, Lahrach Mohamed, El Bouihi Mohamed, Mansouri Hattab Nadia
Sch J Med Case Rep | 336-339
DOI : 10.36347/sjmcr.2021.v09i04.007
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Mediastinitis is a serious complication of cervicofacial cellulitis secondary to the spread of infections developed from a dental focus to the mediastinum. The first signs are sometimes crude and can lead to diagnostic delay. The key exam is a cervical and thoracic CT scan. Its treatment consists of a large tissue excision associated with antibiotic therapy directed against aero-anaerobic germs. We report the case of an immunocompetent patient with dental cervical cellulitis complicated by suppurative mediastinitis.
Obstructive Sleep Apnea in Patient with Myasthenia Gravis – A Case Report
Dr. Natraj M, Dr. Gulnar Begum, Dr. S. P Burma
Sch J Med Case Rep | 340-341
DOI : 10.36347/sjmcr.2021.v09i04.008
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About 30% of the patients with Myasthenia Gravis (MG) develop respiratory muscle weakness. Exacerbation of myasthenia gravis can cause severe respiratory muscle weakness leading to respiratory failure requiring mechanical ventilation. Sleep disorder breathing is seen in about 40 to 60% of patients with myasthenia gravis. Continuous positive airway pressure (CPAP) will not only reverse sleep disordered breathing but also weakness and fatigability during daytime called as “proximal weakness”. Here we report a case of 51 years old male myasthenia gravis patient diagnosed with obstructive sleep apnea (OSA). After initiation of CPAP therapy patients OSA symptoms improved along with his paradoxical weakness.
‘Double Tap’ Gunshot Injury to the Head: A Case Report and Review
Pawan Mittal
Sch J Med Case Rep | 342-345
DOI : 10.36347/sjmcr.2021.v09i04.009
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Atypical gunshot injuries are not very common findings in routine autopsies. A case of gunshot wound to the head is herein reported where two rapid successive shots from a double tap firing lead to a unique patterned injury over the occipital region of the skull. Differentiation from the tandem/piggyback shot was necessary and was made on the basis of wounds’ appearances and detailed circumstantial information. A review of the tandem bullet phenomenon in this regard was made and also a few cases belonging to the finding of double tap gunfire in forensic pathology as well as anthropological contexts were studied in details. The pathologist must be aware of both of the phenomena due to their close relation, in order to fully elucidate the autopsy findings, attesting the witness testimony and the facts relating to a legal investigation.
Steroid-Induced Serous Retinal Detachment in a Patient with Polymyalgia Rheumatica
Hironori Takahashi, Yuka Kasuya, Shinji Makino
Sch J Med Case Rep | 346-348
DOI : 10.36347/sjmcr.2021.v09i04.010
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An 82-year-old man with polymyalgia rheumatica was referred for ophthalmological examination. On ophthalmic examination, his best-corrected visual acuity (BCVA) was 20/40 in the right eye and 20/20 in the left eye. Fundus examination was unremarkable in the left eye, but epiretinal membrane was observed in the right eye. There was no SRD on optical coherence tomography (OCT) in the right eye. The patient was treated with oral prednisolone (10 mg daily), and his symptoms subsided rapidly. However, 1 week after the administration of prednisolone, his right BCVA deteriorated to 40/200. OCT showed serous retinal detachment (SRD) involving the fovea in the right eye. We diagnosed our patient with steroid-induced SRD. SRD gradually improved with the reduction of the prednisolone dose. Clinicians should be aware of CSC development after glucocorticoid therapy. If possible, the glucocorticoid should be discontinued and replaced by an alternative.
Unilateral Central Areolar Choroidal Dystrophy
Rika Tsukii, Shinji Makino
Sch J Med Case Rep | 349-351
DOI : 10.36347/sjmcr.2021.v09i04.011
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A 62-year-old man was referred to our clinic for an ocular fundus abnormality discovered during a medical checkup. He had no subjective complaints. Ophthalmoscopic examinations of the fundi did not reveal any abnormalities in the left eye. In the right eye, a round to oval area of hypopigmentation was seen in the macula, and normal fundus coloration was maintained in the fovea of the right eye. Fundus autofluorescence showed hypoautofluorescence corresponding to the area of hypopigmentation. Optical coherence tomography demonstrated disruption of the ellipsoid zone (EZ) corresponding to the area of hypopigmentation. However, the EZ was relatively preserved in the fovea of the right eye. Based on these collective findings, we diagnosed our patient with unilateral central areolar choroidal dystrophy (CACD). CACD is commonly observed in both eyes. Our findings may contribute to a better understanding of this rare condition.
Immune Hydrops Fetalis: A Case Report
Bahaaedin A. Elkhader
Sch J Med Case Rep | 352-353
DOI : 10.36347/sjmcr.2021.v09i04.012
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Hydrops fetalis is known as fluid accumulation in more than one location in the fetus. It can be classified into two types: immune or nonimmune. The second type is more common, due to improve in primary health care occurrence and mortality of the first one has reduced. A 30 years woman from the village with 27 weeks pregnancy, her blood group B negative. Sonography showed generalized body edema which indicated immune hydrops fetalis; which is considering rare nowadays. She had put under observation for further management.
Persistent Pupillary Membrane
M. Zakoun, S. Belghmaidi, M. Maslik, I. Hajji, A. Moutaouakil
Sch J Med Case Rep | 354-355
DOI : 10.36347/sjmcr.2021.v09i04.013
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A 2-year-old girl of nonconsanguineous parents presented for discreet esotropie revealing a unilateral persistent pupillary membrane of the right eye responsible of amblyopia of deprivation. The examination under sedation revealed a persistent thick pupillary membrane and visual blocking without any other associated anomaly.
Laryngeal Involvement in Systemic Lupus Erythematosus
Soukaina Oumlil, Jaouad Yousfi, Mouna Zahlane, Lamiaa Essaadouni
Sch J Med Case Rep | 356-357
DOI : 10.36347/sjmcr.2021.v09i04.014
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Laryngeal involvement during lupus erythematosus is very rare and exceptionally revealing. The clinical manifestations could be quite varied. We report the observation of an 18-year-old patient who was admitted for pericardial tamponade associated with inflammatory arthralgia, photosensitivity and malar rash. Biological workup showed lymphopenia, positive antinuclear antibodies at 1/1280 with a homogeneous fluorescence and positive anti-dsDNA at 300 IU. Urine protein test was positive at 4.2g/day revealing a class IV lupus nephritis. Four months later, the patient presented with a sudden onset dysphonia. Laryngoscopy showed paralysis of the left vocal cord. The patient was treated with systemic corticosteroid with a favorable evolution.
Takayasu Arteritis with Systemic Lupus Erythematosus: A Rare Association
Soukaina Oumlil, Jaouad Yousfi, Laila Benjilali, Lamiaa Essaadouni
Sch J Med Case Rep | 358-359
DOI : 10.36347/sjmcr.2021.v09i04.015
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Takayasu arteritis (TA) is a systemic vasculitis typically occurring in young female patients, and still of unknown etiology. This vasculitis rarely coexists with systemic lupus erythematosus (SLE). We report the observation of a 45-year-old patient diagnosed with TAwho presented with upper extremity ischemia and wall thickening with a good response to the association of methotrexateand corticosteroids. Five years later, she presented with bilateral inflammatory arthralgia of the middle joints with malar rash. Biological assessment showed lymphopenia, positive anti-nuclear antibodies at 1/1280 with a homogeneous florescence, positive anti-dsDNA and proteinuria at 4.3g/day. The diagnosis of SLEassociated with TA was established.
Knee and Shoulder Arthritis Revealing Tabetic Arthropathy
B. Bannar, M. Ouali. Idrissi, F. Jaafari, B. Boutakioute, N. Cherif Idrissi El Ganouni
Sch J Med Case Rep | 360-363
DOI : 10.36347/sjmcr.2021.v09i04.016
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The tabetic arthropathy is a destructive disease secondary to neurogenic infection tréponème. It has become exceptional with early treatment of syphilis [1]. A retrospective study of three cases, collected from the Arrazi hospital radiology department. All our patients consulted for joint deformity and instability. We reviewed the records of the osteoarticular and neurological clinical examination, as well as the radiological and biological examination; the 3 patients (men and 2 women) are treated on average for 50 years. A history syphilitic chancre is found in two cases. Neurological examination notes a patellar shock and osteo articular deformation, Joint involvement affects the knees in 2 cases and the shoulder in one case, TPHA and VDRL are positive in the blood in all patients and also in the cerebrospinal fluid. The radiological assessment shows a destruction and deformation osteoarticular in all cases. Treatment is medical with penicillin and orthopedic with orthosis. Tabetic arthropathy, an exceptional affection, is one of the complications of the syphilis its prevention relies on the treatment of the syphilis at an early stage, before the onset of the articular and neurologic forms, the management of which remains very difficult [2].
Intramedullary Osteoid Osteoma: Two Cases Reports and Review of Literature
Badiaa. Bannar, F. Jaafari, Z. Btissam, D. Basraoui, H. Jalal
Sch J Med Case Rep | 364-366
DOI : 10.36347/sjmcr.2021.v09i04.017
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Osteoid osteoma is a benign primary bone tumor. This tumor is relatively common, represents 12% of all benign bone tumors and about 2 to 3% of all bone tumors. We report two new cases of histologically confirmed intramedullary osteoid osteoma. In 8-year-old and 9-year-old girls who consulted for chronic intermittent pain in the left leg onset, and worsened over time with discreet swelling in relation to the whole evolving in a context of apyrexia and conservation of the general condition, the two patients underwent a satandard x-ray, CT and MRI of the left leg.
Spontaneous Spinal Epidural Hematoma: A Case Report and Literature Review
Badiaa Bannar, F. Jaafari, B. Zouita, D. Basraoui, H. Jalal
Sch J Med Case Rep | 367-369
DOI : 10.36347/sjmcr.2021.v09i04.018
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Spontaneous spinal epidural haematoma is defined as a bloody effusion in the epidural space occurring outside of any traumatic context. It is a rare but serious condition whose etiopathogeny is not always clear. The typical symptomatology is suggestive. Any suspicion of epidural haematoma should motivate an urgent diagnostic and therapeutic approach because the functional and sometimes vital prognosis is at stake. This is a case of rapidly progressive tetraparesis in a 22 year old woman, pregnant at 32 weeks' gestation with no notion of spinal trauma and no particular history. The medical imaging by angiography and MRI had made it possible to eliminate a vascular malformation and to make the diagnosis. The patient underwent emergency surgery and the postoperative course was simple. Symptomatic cervical epidural haematomas must be diagnosed early in order to consider appropriate treatment. The patient's functional and even vital prognosis will depend on this treatment.
Trailing Exophthalmos Revealing Neurofibromatosis: In A Case Report and Review of the Literature
B. Zouita, B. Bannar, M.Ranib, D. Basraoui, H. Jalal
Sch J Med Case Rep | 370-372
DOI : 10.36347/sjmcr.2021.v09i04.019
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Neurofibromatosis 1is the most common phacomatosis and neurofibromatosis, with an incidence of 1/2500 births. Transmitted in the autosomal dominant mode, it results in the presence of tumors mainly of the skin, cerebral and peripheral nerves, and in bone and vascular dysplasias. In this presentation, we report the case of a 4-year-old girl, who had consulted for a trailing exophthalmos for two years without any particular pathological history, but the scanner objected to sphenoidal dysplasia with right hemi-megalencephaly, in front of the worsening of her exophthalmos, an MRI was performed with clinical reassessment which demonstrated the appearance of café-au-lait spots with OBNIs and a plexiform neurofibroma on MRI.
Original Research Article
April 22, 2021
Imaging of Encephalic Meningiomas (About 142 Cases)
Hicham.Jalal, B.Bannar, M.Moulattaf, Z.Benyaich, F. El hajjhouji, K.Aniba, H.Ghanane, S. Ait ben ali
Sch J Med Case Rep | 373-383
DOI : 10.36347/sjmcr.2021.v09i04.020
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Objective: To analyze the contribution of cross-sectional imaging (CT and MRI) in the etiologic and topographic diagnosis of encephalic meningiomas. Material and methods: Retrospective study of 142 cases of encephalic meningiomas collected over an 11 year period between January 2004 and November 2016. 73 patients underwent CT scans without and with iodinated contrast injection, and brain MRI was performed in 69 patients in sagittal T1, axial T2, and flair sequences and in multiplanar sequences after gadolinium injection. Results: The average age of our patients was 45.10 years with extremes ranging from 12 to 80 years, with a clear female predominance (75%). The meningiomas were located in the convexity in 37% of cases, at the base of the skull in 21% of cases, in the false brain and para sagittal in 10% of cases. 60% of the meningiomas were of meningothelial type. Conclusion: Meningiomas are benign tumors developed from arachnoid cells. They represent 15% of intracranial tumors, and are supratentorial in 90% of cases. Through our series and a review of the literature, we analyze the interest of CT and MRI in the topographic diagnosis, lesion assessment and follow-up of meningiomas.
Encrusted Uropathy Associated with Cutanous Lesion and Renal Failure
H. El Mortaji, A. Chehboune, B. Boutakioute, M. Ouali Idrissi, N. Cherif Idrissi Ganouni, N. Elaatoul, O. Hocar, S. Amal
Sch J Med Case Rep | 384-386
DOI : 10.36347/sjmcr.2021.v09i04.021
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Encrusted uropathy is a rare condition in which infection by ureas germs, most commonly Corynebacterium urealyticum, can lead to urinary tract calcification. Moreover, it usually occurs in immunocompromised patients, especially in renal transplants patients or patients with a history of previous urological procedures. The diagnosis is made easy thanks to the contribution of imagery, combined with the measurement of urinary pH and the isolation of the responsible germ. We describe the case of a 62 year old male patient with an alkaline encrusted uropathy in native kidneys associated with cutanous lesions and complicated with a renal failure and vein thrombosis.
Fat within Hydatid Cysts: An Atypical Presentation
H. El Mortaji, A. Chehboun, M. Benzalim, S. Alj
Sch J Med Case Rep | 387-388
DOI : 10.36347/sjmcr.2021.v09i04.022
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The presence of fatty material in a hydatid cyst is a rare and atypical presentation that suggests communication with biliary tree. Few cases have been reported in the literature. Imaging features allow to show the presence of fatty material within the cyst thanks to the density measurement in CT, it also allows to show signs in favor of this communication. We report three cases of hepatic hydatid cysts with fatty component.
Cerebral Fat Embolism with No Lung Dysfunction: About A Case Report
H. El Mortaji, A. Chehboun, B. Boutakioute, M. Ouali Idrissi, N. Cherif Idrissi
Sch J Med Case Rep | 389-392
DOI : 10.36347/sjmcr.2021.v09i04.023
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Cerebral fat embolism syndrome is a variant of fat embolism syndrome characterized by a predominance of the neurological manifestations. It typically occurs in patients with bone fractures, usually long bones of the lower limb. The absence of pulmonary or dermatological manifestations on the initial presentation may delay the diagnosis of cerebral fat embolism. Magnetic resonance imaging is the recommended imaging modality for patients with suspected cerebral fat embolism. We report the case of a cerebral fat embolism with no lung dysfunction in a trauma patient.
Primary Vaginal Clear Cell Adenocarcinoma: Case Report with Literature Review
Puja Chatterjee, Dipanwita Banerjee, Manisha Vernekar, Ranajit Mandal
Sch J Med Case Rep | 393-397
DOI : 10.36347/sjmcr.2021.v09i04.024
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Very few cases of Primary Vaginal Clear cell Adenocarcinoma (PVCAA) have been reported in literature. A multiparous lady aged 52 years presented with bleeding per vaginum for 1 week. On examination 3x3 cm ulceroproliferative growth involving lower third with subvaginal extension seen. On colposcopy cervix was normal. The uterus and ovaries were normal on imaging. Biopsy from the mass revealed Clear Cell carcinoma. She underwent radical vaginectomy, distal urethral resection(approx 3cm), bilateral groin node dissection and lotus flap reconstruction of defect. Histopathology showed Clear Cell Carcinoma of vagina, Stage III. Adjuvant chemotherapy with cisplatin and paclitaxel 3 weekly for 6 cycles was followed by adjuvant External Beam Radiotherapy. Patient had presented with occasional involuntary dribbling of urine following the surgery which was managed with foleys catheterisation. The incontinence resolved without any intervention one month following radiotherapy. The patient has been recurrence free for past 3 years. The tumour board faced difficulty in taking decisions due to dearth of reported cases and consensus guidelines, prompting the authors to report the case.
Elderly Male with Retroperitoneal Myxoid Liposarcoma: An Unsual Presentation- A Case Report
Dr. Sarita Nibhoria, Dr. Ekta Rani, Dr. Amandeep Kaur, Dr. Shilpa, Dr. Navjot Kaur
Sch J Med Case Rep | 398-400
DOI : 10.36347/sjmcr.2021.v09i04.025
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Retroperitoneal sarcomas are rare neoplasms that account for only 1%-2% of all solid tumors and 5% of primary retroperitoneal liposarcomas are reported as myxoid or round cell liposarcoma [1]. We report the case of a 60-year-old male with a retroperitoneal myxoid liposarcoma of 22 × 15 × 8 cm in size. The only symptoms were persistent pain and progressive tenderness of the abdomen lasting for two months. The mass was radically excised during laparotomy. CT and MRI were useful to clarify the site of origin of the tumor but final diagnosis was based on histological findings.
Interest of Rehabilitation in Idiopathic Peripheral Facial Palsy in Children: A Case Report
Davelle Doungou Ngandzali, Hasna Ouazzani, Asma El Hanafi, Karima Chgora, Youness Abdelfettah
Sch J Med Case Rep | 401-403
DOI : 10.36347/sjmcr.2021.v09i04.026
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Idiopathic peripheral facial palsy in children is a rare entity that often has a good prognosis. The use of rehabilitation treatment is one of the therapeutic means proposed. We report the case of an 8-year-old girl who presented with idiopathic peripheral facial palsy classified as Grade IV according to House Brackmamn. His management included medical treatment as well as rehabilitation coupled with personalized self-rehabilitation. The evolution was marked by the significant improvement at the end of the sessions to the Grade I-classified. Rehabilitation has great benefits aesthetic as well as in motor recovery.
Overdose of Digoxin Leading to Thrombocytopenia: Exceptional Side Effects: A Case Report
L.K. Mohamed Moulay, K.D Amedimelé, G. Gansé, C. Tibou, N.Charei, M. EL Jamili, D. Benzaroual, S. El Karimi, M. El Hattaoui
Sch J Med Case Rep | 404-408
DOI : 10.36347/sjmcr.2021.v09i04.027
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Digoxin is extracted from digitalis and is commonly used in patients with atrial fibrillation and in patients with heart failure. Advanced digitalis intoxication can have a fatal outcome, particularly in patients with underlying cardiac dysfunction (1). Drug-induced thrombocytopenia (DITP), although frequent, remains exceptional in the event of overdose with digoxin. An overdose of Digoxin is usually iatrogenic and mainly leads to cardiac effects but can also cause severe thrombocytopenia. However, this latter complication related to digoxin is “exceptional”. The lifelong prognosis does not depend on a hemostasis disorder but rather on a secondary cardiac arrhythmia. We hereby report the observation of a 62- year-old patient followed for a dilated cardiomyopathy with a severe left ventricular dysfunction, and also an atrial fibrillation treated with acenocoumarol and digoxin. She has been admitted to the emergency room due to a partial loss of consciousness associated with dizziness and vomiting. Hence, we will discuss here explanatory approaches to the unresolved mechanism of this undesirable effect, scarcely described in the literature.
Spontaneous Orbital Hematoma Induced by VALSAVA Maneuver
N. Inzale, D. Jaafari, H. Atidi, S. Boutgayout, S. Bleghmaidi, I. Hajji, A. Moutaouakil
Sch J Med Case Rep | 409-411
DOI : 10.36347/sjmcr.2021.v09i04.028
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Spontaneous intra-orbital hematoma is a rare, potentially serious condition, rapidly endangering the visual prognosis by affecting the optic nerve. It associates in its typical form a painful exophthalmia of brutal installation and oculomotor problems. Its etiologies are numerous and its diagnosis in the absence of an evocative context, relies mainly on anamnestic and radiological findings, particularly those provided by angio-MRI. This article illustrates a case of intra-orbital hematoma induced by the Valsalva maneuver, highlighting the fundamental role of anamnestic, clinical and radiological investigation in the etiological diagnosis of this pathology.
Original Research Article
April 27, 2021
Personalized 3D Printed Molds, A Novel Economical Solution for Cranioplasty
Elhajjami A, Boutakioute B, Ouali Idrissi M, Idrissi Ganouni N, Benyaich Z, Ghannane H, Ait Benali S
Sch J Med Case Rep | 412-415
DOI : 10.36347/sjmcr.2021.v09i04.029
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Objectives: Customized cranioplasty implants are anatomically more accurate than manually shaped implants but remain costly. We describe a cost-effective technique of producing customized cranioplasty implants with the use of 3-dimensional (3D) printed molds. Methods: The patient had a left parietal cranial defect after a craniectomy for cranial trauma. A 3D image of his skull was obtained from computed tomography (CT) scan images. The image of the implant was generated by a digital subtraction mirror-imaging process using the normal side of his cranium as a model. Intraoperatively, the mold was put in a sterile bag and then used to cast a customized implant subsequently trimmed before fixation. Results: The patients had excellent cosmetic results and underwent postoperative CT scans that showed excellent restoration of the symmetrical contours of the cranium. No neurologic or infectious complications occurred over a 6-month follow-up for the patient. Conclusions: Making customized cranioplasty implants via 3D printed polylactic acid molds is a cost-effective technique for delayed reconstruction of various cranial defects.
Scorpion Sting Complicated by Atypical Posterior Reversible Encephalopathy A Case Report With Review of the Literature
F. Zahra Abakka, A. El Masloumi, I. Zouita, D. Basraoui, H. Jalal
Sch J Med Case Rep | 416-418
DOI : 10.36347/sjmcr.2021.v09i04.030
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Posterior reversible encephalopathy (PRES) is a clinico radiological syndrome, which manifests itself by headaches, confusion, consciousness disorders or during a sudden rise in blood pressure but can be seen in other circumstances, such as during an immune reaction or a systemic infection. Its mechanism is explained by a lesion of the blood-brain barrier leading to a reversible vasogenic edema. The scarcity of sympathetic innervation of the posterior cerebral territories explains its usual localization. We report the case of an 18 years old girl who presented with generalized tonic-clonic seizures following a scorpion bite, which yielded to Diazepam. An emergency brain MRI was performed, showing bilateral and symmetrical signal abnormalities of the posterior cortico-subcortical territories and basal ganglia, compatible with an atypical PRES syndrome. The diagnosis of PRES syndrome complicating a scorpion bite was retained.
Patella Cubiti: Rare Anatomical Variation Case Report and Review of the Literature
M Ouali Idrissi, F. Zahra Abakka, Y. Zouine1, B. Boutakioute, N. CherifIdrissi El Ganouni
Sch J Med Case Rep | 419-420
DOI : 10.36347/sjmcr.2021.v09i04.031
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The Cubiti patella is a very rare anomaly characterized by the non-union of the olecranon to the proximal ulna. We report the case of a 45-year-old patient admitted with chronic right elbow pain and no known history of trauma. The diagnosis revealed a patella Cubiti on standard radiography, which was mistaken for an olecranon fracture.
Ovarian Carcinosarcoma
Fouzia El Hilali, Ezza Lemrabott, Sanaa Errarhay, Nissrine Mamouni, Chahrazed Bouchikhi, Abdelaziz Banani
Sch J Med Case Rep | 421-423
DOI : 10.36347/sjmcr.2021.v09i04.032
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Ovarian carcinosarcoma or mixed müllerian malignancy is a very rare and aggressive biphasic histological entity that contains both carcinomatous (from epithelial tissue) and sarcomatous (from connective tissue) histological components. It occurs mainly in postmenopausal women and is often diagnosed at an advanced stage. Given the rarity of this tumor there is no elaborate therapeutic consensus, and the management is based on the recommendations of retrospective studies, which consists of an optimal surgical cytoreduction, followed by radiotherapy and chemotherapy, or chemotherapy alone. Its prognosis is very poor with a 5-year survival rate of 28.2%.
Splenic Lymphangioma: Case Report
Baadi F, Zitouni K, Boutakioute B, Ouali Idrissi M, Cherif Idrissi Ganouni N
Sch J Med Case Rep | 424-426
DOI : 10.36347/sjmcr.2021.v09i04.033
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Lymphangiomas are benign congenital malformations of the lymphatic vessels that manifest mainly in pediatric patients and infrequently in adults. The usual site for lymphangiomas is the head and neck region; however, they can occur in many different body organs, either as a systemic disease called lymphangiomatosis syndrome or as a single organ lesion [1]. They rarely involve the spleen, especially in adults where they are found incidentally. The differential diagnosis is usually broad, and making an accurate diagnosis pre-operatively is a challenging task for clinicians. The treatment of choice is total resection of tumor in order to prevent serious complications [2]. In this paper, we present one case of splenic lymphangioma in a 47-year-old woman who presented with abdominal pain.
Granular Cell Tumor of the Hypopharynx Treated by Cervical Surgery: A Case Report
Ait Taleb Oum’Hand Hajar, Boumendil Ikram, Allouch Ihsane, Nitassi Sophia, Bencheikh Razika, Benbouzid M A, Oujilal Abdelilah, Essakalli Leila
Sch J Med Case Rep | 427-430
DOI : 10.36347/sjmcr.2021.v09i04.034
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This clinical case describes an unusual case of an uncommon benign neoplasm named Abrikossoff’s tumour or granular cell tumour (GCT) that generally occurs in the fourth and the sixth decades of life. Its location at the hypopharyngeal area is extremely unusual. Here we describe a rare case of 58-year-old female who presented with history of dysphagia followed by dysphonia then a dyspnea that had been gradually worsening.
Original Research Article
April 29, 2021
Medical 3D Printing for the Radiologist, Experience of Marrakech University Hospital Department of Radiology
Elhajjami A, Boutakioute B, Ouali Idrissi M, Idrissi Ganouni N
Sch J Med Case Rep | 431-438
DOI : 10.36347/sjmcr.2021.v09i04.035
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Three-dimensional printing is a manufacturing procedure in which objects are formed by fusing or depositing materials to create a 3D model. Different printers are used for 3D printing. Medical applications for 3D printing are expanding rapidly and are expected to revolutionize health care. 2D radiographic pictures are converted to computerized 3D prints creating anatomical and clinical structures. There are five steps to technically create a 3D model from image and these steps are image acquisition, segmentation, file optimization, choosing materials and printers and print and post processing of 3D medical model. We report the experience of the radiology service at Marrakech university hostpital using a low cost FDM printer. The results of different cases are discussed in this article.
Metatarsal Stress Fracture: Different Imaging Aspects, a Case Report
M. Ouali Idrissi, A. Elhajjami, B. Boutakioute, N. Idrissi Ganouni
Sch J Med Case Rep | 439-440
DOI : 10.36347/sjmcr.2021.v09i04.036
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Stress Fracture is a slightly common bone fracture that occurs due to disproportion of the mode of mechanic chronic stress and the strength of the bone. It can be Occur Either due to normal stress on diseased bones which called an insufficient fracture or due to strong stress on the normal bone which called a fatigue fracture.
Neurotrophic Ulcer Complicated By Stromal Melting
D. Jaafari, N. Inzale, S. Boutgayout, H. Atidi, S. Belghmaidi, I. Hajji, A. Moutaouakil
Sch J Med Case Rep | 441-442
DOI : 10.36347/sjmcr.2021.v09i04.037
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Neurotrophic keratitis results from partial or complete denervation of the cornea from various origins, including viral. We report the case of a monophthalmic patient, followed for dry eyes. She was pseudophakic patient who presented, after a cataract surgery, a neurotrophic ulcer complicated by stromal melting.
F-Fluorocholine PET/CT in the Assessment of Primary Hyperparathyroidism
Chehab Nasreddine
Sch J Med Case Rep | 443-445
DOI : 10.36347/sjmcr.2021.v09i04.038
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Confirmation and localization of parathyroid adenomas remain difficult in imaging to date. Often, several imaging tests are necessary for the location of the adenoma (echography, scintigraphy). Recently, limited series have shown a potential benefit of PET to fluorocholine. Here we report the case of a patient initially operated for primary hyperparathyroidism with persistence of a high PTH in post-operative suites and whose MIBI scintigraphy did not detect a persistent parathyroid nodule.
Cyst of the Nuck Canal: A Rare Cause of Painful Inguinal Swelling in Women Who Are Not To Be Misunderstal
Mohamed Ait Chtouk, Labretesche Gracia Christ Gakosso, Soumia Alj
Sch J Med Case Rep | 446-448
DOI : 10.36347/sjmcr.2021.v09i04.039
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The cyst of the Nuck canal often called female hydrocele is a rather rare pathology due to the persistence of the peritoneo-vaginal canal in women. Frequently described and observed in pediatric settings, its revelation in adulthood is very rare and has been very much described in the literature. We report here the case of a 20-year-old patient, with a history of right inguinal herniated cure not strangled in childhood, with the notion of appendectomy 07 months ago. The reason for consultation was a hyperalgic and disabling right inguinfaction evolving in an apyretic context without transit disorders. Emergency abdominal ultrasound revealed a cystic formation in relation to the right inguinal ligament, oblong in shape, with finely echogenic contents, fine wall, no partition, no vegetation, or endokystic intestinal content. The exploration was supplemented by an abdominal CT scan. This observation reveals the place of imaging in the differential diagnosis of painful pelvic swelling in women.
Diabetic Mastopathy Simulating Breast Cancer: A Case Report with Review of the Literature
F. Z. Abakka, I. Zouita, S. Kirami, D. Basraoui, H. Jalal
Sch J Med Case Rep | 449-451
DOI : 10.36347/sjmcr.2021.v09i04.040
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Diabetic mastopathy (DM) is a pathological entity of recent description, it is rare and benign; occurring in young patients with type I diabetes, or with an autoimmune disease. Clinically, it simulates breast cancer. Complementary examinations are not very informative. The diagnosis of certainty is histological. Through an observation of DM in a diabetic patient, under insulin since the age of 10 years, we recall the clinical, radiological and evolutionary aspects of this affection.
Lipomyelomeningocele: A Cause of Closed Dysraphism with Fatty Contingent. Case Report and Review of the Literature
I. Zouita, F. Z. Abakka, J. F. Adjimabou, D. Basraoui, H. Jalal
Sch J Med Case Rep | 452-454
DOI : 10.36347/sjmcr.2021.v09i04.041
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Lumbosacral lipomasrepresent the most common forms of occult spinal dysraphism. Lipomyelomeningocele is a rare birth defect of the spine. It’s a lipoma that is tightly attached to the dorsal surface of a neural placode and extend dorsally through spina bifida to be continuous with subcutaneous fat. MRI plays an essential role in the diagnosis and treatment. We report the case of an 18-month-old infant in whom we detected a lipomyelomeningocele during the exploration of scoliosis.
Cerebral Mycotic Aneurysm Complicating Infectious Endocarditis Case Report and Review of the Literature
F. Z. Abakka, I. Zouita, S. Tadsaoui, D. Basraoui, H. Jalal
Sch J Med Case Rep | 459-462
DOI : 10.36347/sjmcr.2021.v09i04.043
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Mycotic aneurysm is a redoubtable complication of infectious endocarditis which is the source of many other complications and is generally difficult to diagnose. They are secondary to the migration vegetations in the cerebral circulation, which, depending on its septic nature or not, can give different clinical pictures: ischemic embolic vascular accidents, meningitis, cerebral hemorrhages and brain abscesses. We report in this article a case of a 2-year-old child admitted to a picture of sudden hemiplegia evolving in a febrile context and in whom radiological exploration objectified ischemic strokes of different ages with individualization of a sacciform aneurysm of the third portion (M3) of the right sylvic artery suggesting a cerebral mycotic aneurysm complicating an infectious endocarditis which was confirmed by transthoracic ultrasound.
Median Nerve Fibrolipoma
M. Ouali Idrissi, F. Jaafari, B. Boutakioute, N. Cherif Idrissi El Ganouni
Sch J Med Case Rep | 463-464
DOI : 10.36347/sjmcr.2021.v09i04.044
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Nerve tumors are of the order of 5% of tumors of the hand, neurofibroma and schwanoma are the most frequent. Fibrolipoma is a rare benign tumor that develops at the expense of peripheral nerves of unknown origin. macroscopically, it appears in the form of a lobulated formation with a double fatty and tissue component. Microscopically, this tumor is characterized by the presence of adipose and connective tissue infiltrating the envelopes of the nerve. surgical management involves microsurgical procedures. We report the observation of an 8-year-old patient with no particular pathological history, was referred to our department with slowly growing mass on the palmar surface of the left hand and who have been diagnosed with neurofibroma of the median nerve by imaging.
Delirium Revealing a Parathyroid Adenoma
Jebbar Nourddine, Elkaissi Jaber, Maaroufi Ayoub, Diai Abdellatif, Jbili Nabil, Bibiche Lotfi, Kechna Hicham, Laoutid Jaouad
Sch J Med Case Rep | 465-467
DOI : 10.36347/sjmcr.2021.v09i04.045
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Primary hyperparathyroidism is quite common. The most forms are now seen in women after menopause and appear to have little evolution. Support surgery is imperative for primary hyperparathyroidism occurring before age 50, and in symptomatic forms, especially in cases of bone loss.
Primary Clear Cell Carcinoma of the Vagina Not Associated with Diethylstilboestrol A Case Report and Literature Review
Oumayma Bounid, Mehdi Raouah, Rokkaya Iharti, Youness El-khadir, Yassine Bouchabaka, Hind Riahi, Mouna Darfaoui, Issam Lalya, Abdelhamid Elomrani, Mouna Khouchani
Sch J Med Case Rep | 468-470
DOI : 10.36347/sjmcr.2021.v09i04.046
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Clear cell adenocarcinoma is a histological type rarely found among cancers of the vagina. It is often described in young women previously exposed to diethylstilboestrol (DES) taken by mothers during pregnancy. Its prognosis is pejorative, requiring early and modified management according to each case. Given the insufficient data in the literature, we find it important and useful to report and discuss through the rare case of our elderly patient without any notion of exposure to DES, the diagnosis, the therapeutic management and the prognosis of this type of cancer.
Lung Carcinoid Tumor: A Case Report
Selma Abdala, Salma Aitbatahar, Hanane Raiss, Hicham Fennane, Yassine Msouger, Lamyae Amro
Sch J Med Case Rep | 471-473
DOI : 10.36347/sjmcr.2021.v09i04.047
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Introduction: primary carcinoid tumors of the lung are rare tumors, they account approximately 0.5 to 5% of all lung malignancies and roughly 20 to 30% of all carcinoid tumors. Early diagnosis is extremely important in order to allow the surgical excision which still the main treatment. Presentation of case: We describe a case of a twenty years old woman, who complained from intermittent dry cough with bloody sputum for six months, clinical examination showed left basithoracic condensation syndrome, chest Xray revealed homogeneous dense opacity of the left paracardiac fold. CT scan showed a left mediastino-pulmonary lesion process which comes into contact with the left ventricle with infiltration of its wall, it includes the proximal part of the left lower lobe bronchus (LLLB), with reduction of its caliber, without mediastinal lymphadenopathy or pleuropericardial effusion. The bronchoscopy with biopsy of the endobronchial lesion was performed; the histopathology study confirmed the diagnosis of carcinoid tumor. The treatment of the choice was complete resection left inferior lobectomy. The patient was discharged home within 7 days without complications. Conclusion: A carcinoid tumor may be considered a challenging disease due to its infrequency, a good index of suspicion and knowledge of the tumor is very important for a good outcomes
Pseudo Tumoral Form of Mediastinal Tuberculosis: Case Report
F. Z. Abakka, I. Zouita, Y. Zouine, D. Basraoui, H. Jalal
Sch J Med Case Rep | 455-458
DOI : 10.36347/sjmcr.2021.v09i04.042
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Mediastinal pseudotumoral tuberculosis is a rare form of Mycobacterium tuberculosis infection, characterized by marked diagnostic difficulty due to the absence of specific clinical or biological signs and deceptive imaging mimicking a neoplastic pathology. In this article, we report a case of mediastinal pseudotumoral tuberculosis that was treated with a thoracic CT scan and a dorsal MRI scan, which showed a posterior mediastinal lesion process infiltrating the spinal canal and the dorsal soft tissues and suggesting a tumoral or infectious origin. The tubercular origin was retained in the face of presumptive arguments and the patient was treated as lymph node tuberculosis and put on anti-bacillary drugs based on streptomycin, rifampicin, isoniazid and pyrazinamide according to the 2RHZ/4RH protocol with a very good clinical and paraclinical evolution.
