Journal of the College of Physicians and Surgeons--Pakistan : JCPSP
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J Coll Physicians Surg Pak · Dec 2019
Case ReportsTumour-to-tumour Metastasis: Cutaneous Melanoma Metastasizing to Leiomyoma Uteri.
The incidence of melanoma is increasing worldwide. It is known that melanoma frequently progresses to metastatic disease. The aim of this report is to emphasise the metastatic potential of cutaneous melanoma to various body areas, as well as the ability to produce unexpected presentation of the disease. ⋯ The metastasis to uterine leiomyoma was the first site of distant spread. Melanoma is a type of tumour with aggressive and unpredictable behaviour, so metastases to unexpected localisations could occur. A careful examination of patient's body is mandatory, including the remote areas and even benign tumours.
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J Coll Physicians Surg Pak · Dec 2019
Case ReportsThe First Described Case of Bizarre Leiomyoma of the Portal Vein.
Vascular leiomyomas with bizarre nuclei are rare. Differentiation of these tumors from malignant lesions is essential to avoid unnecessary dissection and organ loss in surgery. Herein, we present a 39-year Kosovo woman with a bizarre leiomyoma arising from the portal vein. ⋯ In conclusion, vascular bizarre leiomyomas are rare tumors. It is impossible to diagnose these correctly before surgery. Perioperative use of pathological examination as a frozen section can be helpful to avoid unnecessary surgical procedures.
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J Coll Physicians Surg Pak · Dec 2019
Case ReportsRobot-assisted Laparoscopic Nephroureterectomy for a Nephrogenic Adenoma of Ureter.
Nephrogenic adenoma is a rare and benign tumour of the urinary tract thought to be caused by metaplastic change of native urothelial tissue. The majority of cases arise in the bladder, with very few cases affecting the ureter reported in the literature. Herein, we describe the presentation, diagnostic challenges, and the eventual management of a nephrogenic adenoma of the ureter by robot-assisted laparoscopic nephroureterectomy. Urologists and pathologists should be aware of the potential diagnostic and management pitfalls associated with this rare tumour, as well as the sparsity of evidence with respect to follow-up.
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J Coll Physicians Surg Pak · Dec 2019
Case ReportsPartial Malrotation of Bowel Loops in an Adolescent with Left Hypochondrial Pain.
In the embroyological development, any deviation from physiological midgutrotation results in intestinal malrotation, which may further cause midgutvolulus or intestinal obstruction. It is predominantly a pediatric diagnosis; however, it may occur in adolescent or adult life. A case is presented here of a 17-year boy who came in Accident and Emergency Department, Abbasi Shaheed Hospital with complaint of intermittent and severe intensity pain in left upper quadrant of abdomen. ⋯ He underwent barium enema, which revealed features of intestinal malrotation. He was further investigated with contrast-enhanced CT abdomen for complications, which confirmed the aforementioned abnormal orientation of superior mesenteric vessels and diagnosis of intestinal malrotation without any complication. In summary, any non-specific abdominal complaint with or without intestinal obstruction in an adolescent or adult patient should be investigated for the possibility of intestinal malrotation.
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J Coll Physicians Surg Pak · Dec 2019
Case ReportsA Case of Polyautoimmunity: Celiac Hepatitis, Grave's Disease and Autoimmune Hemolytic Anemia.
Celiac disease (CD) is an autoimmune disorder with high incidence of multi organ involvement; especially, gastrointestinal manifestations and an increased risk of malignancies. Here we report a case of CD with celiac hepatitis, autoimmune hemolytic anemia (AIHA) and Grave's disease (GD) with their complications. Polyautoimmunity requires comprehensive analysis. ⋯ All three diseases were treated afresh with strict adherence to a gluten-free diet (GFD) and carbimazole along with addition of medications for cirrhosis complicated by ascites. This was a rare case where non-adherence to a GFD led to such severe adverse events. A case of celiac hepatitis presenting with such a wide array of signs and symptoms has rarely been reported in the literature and the management of this patient was unique and challenging.