Journal of the College of Physicians and Surgeons--Pakistan : JCPSP
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J Coll Physicians Surg Pak · Apr 2022
Case ReportsNeuroleptic Malignant Syndrome with Normal Creatine Phosphokinase Levels: An Atypical Presentation.
Neuroleptic malignant syndrome (NMS) was initially notified as an adverse effect of an antipsychotic agent called chlorpromazine, in 1956. In the past, several case reports of NMS have been reported, even if they did not meet the proposed diagnostic criteria for it. The diagnostic criteria for NMS include increased muscle stiffness, increased body temperature, elevated creatine phosphokinase (CPK) levels by at least four times the upper limit of normal (ULN), autonomic dysfunction, and an altered mental status. ⋯ Persistent hyperthermia and autonomic symptoms with further deterioration in mental status, led to a working diagnosis of NMS. The patient, thereafter, received bromocriptine, benzodiazepines and continuous intravenous hydration, but his clinical condition deteriorated and he expired after nine days of hospital stay. Key Words: Neuroleptic malignant syndrome, Creatine phosphokinase, Hyperthermia, Muscle stiffness.
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J Coll Physicians Surg Pak · Apr 2022
Case ReportsCutaneous Metastasis from Transitional Cell Carcinoma of Urinary Bladder.
Cutaneous metastases with a prevalence of 5.3% in all malignancies are rarely observed phenomena in dermatology. Bladder cancers constitute 0.84% of cutaneous metastases; and 90% of these are transitional cell carcinomas (TCCs), the commonest bladder malignancy. ⋯ We would like to call attention to these rarely observed skin lesions to prevent delayed diagnosis; and emphasise the use of immunohistochemical staining for the determination of the primary origin of the tumour. Key Words: Cutaneous metastasis, Bladder, Urothelial carcinoma.
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Uterine adenosarcoma is a rare tumor composed of benign epithelium in combination with malignant mesenchymal components. Misdiagnosis is common due to the lack of specific clinical manifestations and the rarity of such tumors in young age groups. The mean age at diagnosis is 58.6 years, and <10% of patients are younger than 40 years. ⋯ Histopathologic examination finally confirmed uterine adenosarcoma. The patient had no evidence of residual tumor or recurrence during six months of follow-up. Key Words: Uterus, Adenosarcoma, Mixed tumor.
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Paratesticular liposarcoma (PLS) is a rare type of genitourinary malignancy in the spermatic cord presenting as scrotal swelling. In this case study, we report an 82-year male who presented with prolonged left scrotal swelling and pain that did not respond to analgesic treatment for one week. His ultrasound confirmed increased fluid content in the left scrotal compartment in the form of septated hydrocele, and hydrocelectomy was planned. ⋯ The pathological examination revealed a dedifferentiated liposarcoma. To our knowledge, this is the first report of liposarcoma of the spermatic cord with hydrocele in the literature. Key Words: Liposarcoma, Spermatic cord, Scrotal swelling, Hydrocele.