Suprasellar tension pneumocyst after transsphenoidal surgery. Case report

Tension pneumocephalus is an uncommon occurrence after transsphenoidal surgery. The author presents an unusual case of postoperative visual deterioration related to expanding air within a suprasellar tumor cavity.     

Suprasellar granular cell tumor

A case of a suprasellar granular cell tumor, approximately 1.5 cm in diameter, in a 68-year-old woman is described. Diagnosis was established postoperatively by histopathological examination of the tumor tissue. The preoperative computed tomographic scan revealed a slightly hyperdense suprasellar mass with strong contrast enhancement. There was no evidence of calcification. The T1-weighted image on magnetic resonance imaging scan showed an isointense tumor with non-homogeneous enhancement after intravenous gadolinium diethylene-triamine-pentaacetic acid. In the proton-weighted image, the suprasellar mass presented a non-homogeneously enhanced signal. A non-homogeneous signal reduction was seen in the T2-weighted image.     

Rhinosporodium: case report

This is the first reported case of rhinosporidiosis in Ibadan, Nigeria. A review of literature shows that the patient came from northern Nigeria where the first case was reported in the country. The organism is difficult to culture and the diagnosis was based on microscopy and histological examination of the polyp. We present the case of recurrent rhinosporidiosis in a 16 year old girl a year after polypectomy in Zaria, northern Nigeria.     

Suprasellar germinomas in childhood and adolescence: diagnostic pitfalls

STUDY OBJECTIVE: To compare the adequacy and efficacy of anesthesia experienced with lidocaine-epinephrine-tetracaine (LET) solution versus LET gel during suturing of uncomplicated lacerations on the face or scalp in children. METHODS: Two hundred children with lacerations of the face and scalp requiring suturing were enrolled in this blinded, randomized controlled trial, in the emergency department of a university-affiliated children's hospital. After the application of anesthetic solution or gel, adequacy of anesthesia was determined before suturing. Efficacy of anesthesia during laceration repair was determined by the length of time after removal of the topical anesthetic to the first sign of discomfort that required additional anesthesia or until suture completion. RESULTS: Adequacy of initial anesthesia was equivalent between LET solution and LET gel. There was a significant difference in efficacy of anesthesia between the LET formulations. There were more patients with complete anesthesia (85% versus 76%), fewer persons with partial anesthesia (5% versus 21%), and more persons with incomplete anesthesia (9% versus 3%) in the gel group. CONCLUSION: LET gel is at least as effective as LET solution and possesses theoretical advantages for topical anesthesia during suturing of uncomplicated lacerations on the face and scalp in children.     

Pseudopneumoperitoneum: a case report

A case of post-traumatic pseudocyst of the pancreas is presented. The elevated and compressed stomach showed an appearance on X-ray film which might be interpreted as free peritoneal air. The term pseudopneumoperitoneum is defined and other causes of this condition are mentioned.     

Hemangiopericytoma: a case report

We describe one case of hemangiopericytoma touching a 44-year-old man. It is a rare vascular tumor originating from pericytes surrounding capillaries. The main typical features of it are the difficulty in doing an histologic diagnosis and the impossibility to make out a reliable prognosis. The therapy of choice is a surgical procedure sometimes in combination with radio- and/or chemotherapy.     

Munchausen's syndrome: case report

A case report of a 31-year old butcher with haemorrhagica histrionica is presented. The patient went to great lengths to induce haematemesis and fake its symptoms to gain admission to hospital. The alarming frequency of admissions and dramatic behaviour of the patient prompted this report.     

Lymphoma lymphoplasmocytoides: a case report

Clinical symptoms and haematological disorders in patients suffering from lymphoplasmatic/lymphoplasmocytoidal lymphoma were presented, 82 patients were examined (median age of 63), all of the in clinical stage IV (ANN Arbor scale). In all of the patients bone marrow was invaded. The most common symptom was enlargement of peripheral lymph nodes (86%) less often abdominal ones (21%). Splenomegalia was found in 55% and hepatomegalia in 49% of patients 35% of patients had anaemia and 38% thrombocytopenia. Close to 1/3 of patients dermatoses were found, in most cases allergic ones. In 7% another cancer was found.     

Enchondroma protuberans: a case report

Epidemiologic studies suggest that moderate amounts of ethanol may reduce cardiovascular risk. The mechanisms of the alcohol-associated risk reduction are not known exactly. Vascular smooth muscle cell proliferation represents an important phenomenon in the pathogenesis of atherosclerosis. Recently, it was suggested that metabolic changes during the postprandial phase may be important in the pathogenesis of atherosclerosis. Therefore, we evaluated the effect of postprandial plasma with and without ethanol on the proliferation of rat vascular smooth muscle cells. Identical meals containing 1 g fat/kg body wt were given with and without ethanol (38 +/- 0.5 g) to eight healthy young men. Blood was drawn hourly during an 8-h postprandial period; the plasma was separated and added to the cell cultures (0.3%, by vol). The proliferative response (DNA synthesis) of these cells was assessed by measuring the incorporation of [methyl-3H]thymidine. The maximal blood ethanol concentration of 11.5 +/- 0.6 mmol/L (mean +/- SEM) was attained within the first hour. The ingestion of the meal with ethanol led to a 20% reduction in the capacity of postprandial plasma to induce thymidine incorporation into smooth muscle cells compared with the meal without ethanol (P < 0.05). These results suggest that ethanol may reduce cardiovascular risk by modulating vascular muscle cell growth during the postprandial period. Considering the amount of time humans spend in the postprandial state during their lifetimes, these findings may be of great importance in the pathogenesis of atherosclerosis.     

Drug induced rhabdomyolysis: case report

Rhabdomyolysis results from skeletal muscle injury leading to the release of intracellular contents into blood and urine. Its diverse aetiology includes severe exercise, muscle trauma or ischaemia, metabolic disorders, infections and exposure to drugs and toxins. Known risk factors include heredity disorders of glycogen and lipid metabolism as well as a history of substance abuse. A case of rhabdomyolysis associated with exposure to opiates and benzodiazepines is described and the pathogenesis and treatment are reviewed. The rhabdomyolysis was complicated by acute renal failure; the patient fully recovered. It is suggested that rhabdomyolysis should be borne in mind in patients presenting with altered mental status, or fluid and electrolyte abnormalities, in particular, if they also give a history of substance abuse.     

Gangrenous streptococcal myositis: case report

Streptococcal infection of the large skeletal muscles is a rare but often rapidly fatal condition that may occur for no apparent reason. Nonsteroidal anti-inflammatory drugs may have an adverse effect on outcome. A high index of suspicion is the key to early diagnosis.     

Bilateral twinning: report of case

Twinning is an anomaly in which one tooth has combined with another or enlarged itself to the point of doubling its substance. A discussion of the nomenclature and a report of bilateral twinning are presented. A possible cause of the twinning events in this case include gemination of the maxillary right and mandibular left canines and fusion of the maxillary left and mandibular right canines with supernumerary teeth.     

Malignant gastric teratoma: case report

Gastric teratomas are rare and usually benign. A 4 month old boy presented with an abdominal mass and computed tomographic and ultrasound examination demonstrated a large multi-loculated tumour which was totally excised. The pathological diagnosis was of a malignant gastric teratoma and 12-month follow-up was uneventful.