Military medicine
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Review Case Reports
Giant Appendicolith: A Case Report and Review of the Literature.
Acute appendicitis is one of the most prevalent causes of an acute abdomen. Although the cause of appendicitis is not completely understood, the theory of luminal obstruction is a popular belief, with appendicoliths being a common etiology. ⋯ We present a young male diagnosed preoperatively on computed tomography to have a large appendiceal mass of 2.2 cm. This case is presented for the rarity of giant appendicoliths along with a review of the literature.
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A 43-year-old white male sought treatment for swelling of the left brow, which started after sustaining direct blunt trauma to the left bony orbit 6 months prior. Magnetic resonance imaging with contrast showed a 5.6 × 2.7 mm T1 bright focus at the anterior aspect of the left supraorbital rim. On the postgadolinium fat-saturated axial T1 images, the lesion demonstrated fat signal but was not suppressed in T1 with fat suppression. ⋯ Orbital lipomas are rare benign neoplasms with only a handful of cases in literature. This is the first report of a posttraumatic encapsulated lipoma presenting on the brow or orbit. Although rare, lipomas should be on the differential of post-traumatic lesions affecting the orbit and the orbital rim.
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Case Reports
Azoospermia Secondary to a Novel X-Autosomal Reciprocal Translocation: 46,Y, t(X:16)(p22.1:p11.2).
Chromosomal translocations occur in 10 to 15% of men with azoospermia. Thirty distinct X-autosomal balanced reciprocal translocations have been reported in the literature thus far. We present a novel case of azoospermia with a karyotype of 46,Y,t(X:16)(p22.1:p11.2). ⋯ They can have limited but successful reproductive outcomes if spermatozoa can be isolated during testicular biopsy. Given the high risk of producing genetically unbalanced embryos, genetic counseling and preimplantation genetic testing is essential before pursuing assisted reproductive technology. This case is the first X-autosomal balanced reciprocal translocations involving chromosome 16 and highlights the importance of the X chromosome during spermatogenesis.
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Synovial Sarcoma is a soft tissue sarcoma with a propensity to imitate a benign neoplasm. It is most common in males 15-40 years old, typically presents as a slow growing painful mass, and often arises insidiously without alarm to the patient. Three patients with synovial sarcomas who had each undergone an index procedure to treat a small presumedly benign mass that was later identified as synovial sarcoma were reviewed. ⋯ Healthcare providers should be aware of the synovial sarcoma's propensity to masquerade as a benign disease and the characteristic clinical and radiological findings. We advocate for a low threshold to obtain advanced imaging and consideration of a tissue diagnosis prior to excision. A referral to an orthopedic oncologist should be considered and biopsy should only be performed where the definitive treatment will take place if malignancy is identified.