Research Desk

Feb 19, 2019

This is a case of a 31-year-old woman with a chondrosarcoma of the hyoid bone. The patient presented with a mass in the left submandibular region. Fine-needle aspiration cytology suggested chondroma, but further imaging investigation with CT revealed an exophytic tumor originating from the body of the hyoid bone. Histopathology of the surgical specimen confirmed the diagnosis of intermediate-grade chondrosarcoma.

Feb 19, 2019

This is a case of occult microscopic basal cell carcinoma arising in a lesion of seborrheic keratosis. There is a 0.8 × 0.7-cm well-defined, brown nodule on the right buttock.  By IHC report, they diagnosed it as a basal cell carcinoma. So, this case indicates that the basal cell carcinoma could arise from seborrheic keratosis and might help to clarify the origin of basal cell carcinoma.

Feb 19, 2019

This case report presents a well-functioning revision total knee arthroplasty (TKA) who suffered a periprosthetic tibia fracture. Initial treatment with plating failed and the fracture had to be revised due to an infectious non-union with a multidrug-resistant Staphylococcus epidermidis, and its eradication was complicated by septic loosening of the patient’s knee arthroplasty. After multiple revisions of the nonunion, a two-stage exchange arthroplasty with a partial replacement of the distal femur due to a bone defect was necessary.

Feb 19, 2019

A 64-year-old woman underwent spinal fusion surgery by the anterior and posterior approach for her scoliosis. She developed leg edema and right pleural effusion 2 months after the surgery. Laboratory findings showed decreased total protein and albumin levels in serum. The color of the thoracentesis sample was pinkish white, and the Triglyceride level in the pleural effusion was high. So, her leg edema was found to be associated with malnutrition and the pleural effusion was caused by chylothorax.

Feb 18, 2019

This is a case report of a 49-year-old woman with a long-standing history of atopic dermatitis since childhood presented with refractory atopic dermatitis on dupilumab, 300 mg subcutaneously, every other week after a loading dose of 600 mg subcutaneously. She is also a k/c/o alopecia universalis. After starting dupilumab for refractory atopic dermatitis, she noted immediate hair regrowth on the scalp. After 8 months of dupilumab use, she had full scalp hair regrowth.

Feb 18, 2019

A 71-year-old patient was presented with sudden quadriplegia secondary to cervical (C2 to T1) epidural hematoma as a result of undiagnosed autoimmune acquired hemophilia A. She underwent emergency cervical laminectomy and evacuation of spinal hematoma with significant recovery in upper limb function. This case highlights the importance of hematological investigations in patients with a spontaneous spinal hematoma.

Feb 18, 2019

A 46-year-old male army colonel sustained blunt injury to the right eye following direct contact with a tennis ball to the closed eyelid. Three hours later, visual acuity was 20/30 in the right eye and 20/20 in the left eye with central corneal abrasion, mild anterior chamber cells, flare, and a localized gray-white oval discoloration in the macula of the right eye. Topical corticosteroid ointment and systemic corticosteroid (50 mg prednisone daily for 5 days) were started. At 20 h following trauma, high-definition SD-OCT and OCTA were obtained through clear cornea.

Feb 18, 2019

The patient is a 43-year-old transgender woman who developed neovaginal SCC 23 years after vaginoplasty. The patient tested positive for high-risk human papillomavirus (HPV). At the time of diagnosis, radiological investigations revealed already existing lymph node and osseous metastases. The treatment consisted of various cycles of chemotherapy and radiation therapy. Unfortunately, the formation of additional metastases, including cerebral, pulmonary, and hepatic metastases, could not be prevented. After comparing the literature on the topic, they conclude that neovaginal carcinoma often appears years and decades after genital reconstruction surgery. They, therefore, recommended the continuation of regular clinical follow-up for transgender women after postoperative follow-up is completed. With this approach, potential lesions may be detected at an earlier stage and a better outcome may be achieved. Follow-up should include neovaginal examination and cytological smear testing. At a later age, they recommended additional regular prostate-specific antigen (PSA) testing and digital rectal examination (DRE). Moreover, transgender women are advised to take part in mammography screening starting at the age of 50, especially when additional risk factors are present.

Feb 18, 2019

A 45-year-old Asian Hindu woman presented with vomiting and imbalance of 1 day’s duration. She had left-sided ataxic hemiparesis with one-and-a-half syndrome with bilateral seventh and right fifth nerve palsy. Magnetic resonance imaging of her brain revealed acute non-hemorrhagic infarct in the right posterolateral aspect of pons and medulla, with normal brain vessels angiography. They described her disorder as a twenty-and-a-half syndrome. She was put on antiplatelet therapy.

Feb 18, 2019

This is the case of cerebral venous thrombosis secondary to hyperhomocysteinemia caused by vitamin B12 deficiency in a 32-year-old Indo-Aryan man. A detailed coagulation workup led us to find the etiology of cerebral venous thrombosis in this patient who followed a strict vegetarian diet and had vitamin B12 deficiency leading to hyperhomocysteinemia.