Case Reports

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http://hdl.handle.net/2003/37848

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  • J. G. Hengstler
    Leibniz Research Centre for Working Environment and Human Factors
    Ardeystr. 67
    D-44139 Dortmund
    Germany

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Leibniz Research Centre for Working Environment and Human Factors
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    Trigeminal trophic syndrome
    (2019-10-16) Zotti, Francesca; Capocasale, Giorgia; Lonardi, Fabio; Zambotti, Tiziano; Nocini, Riccardo; Albanese, Massimo
    Trigeminal trophic syndrome (TTS) is a rare facial/cranial affection that arises in ulcerations, itch and paresthesia. Etiology is debated, however trigeminal nerve damage seems to be frequent in pathogenetic patterns. The disease may affect any region innervated by the trigeminal nerve, especially the maxillary branch. A case of TTS, trigged by allergic reaction to osteosynthetic materials and involving infraorbital nerve, was presented. The feature that makes this case one-off in the literature is the association with osteolytic lesion surrounding infraorbital nerve. Diagnosis and treatment were difficult and multidisciplinary approach was required. Treatments administered were satisfying and signs and symptoms remitted, however patient quitted follow-up. TTS is a rare disease, diagnosis is difficult to be performed and it is often a diagnosis of exclusion. Treatment is challenging and it requires a multidisciplinary approach and a great compliance of patients.
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    Osimertinib as treatment for EGFR exon 20 insertion-positive lung adenocarcinoma
    (2019-10-07) Murano, Chihiro; Igarashi, Akira; Yamauchi, Keiko; Inoue, Sumito; Watanabe, Masafumi
    A 20-year-old woman was diagnosed with stage 4 lung adenocarcinoma with an epidermal growth factor receptor (EGFR) exon 20 insertion gene mutation. Although the patient underwent chemotherapy, her lesions progressed. Liquid biopsy for EGFR T790M mutation showed negative results. After administering osimertinib, reduction of the lesions at the primary site was observed, and the patient’s respiratory condition improved. Previous reports showing successful treatment of EGFR exon 20 insertion-positive lung adenocarcinoma with the standard osimertinib dose of 80 mg are limited. The present case demonstrated that osimertinib could be a possible treatment option for EGFR exon 20 insertion-positive lung adenocarcinoma.
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    Food malabsorption/intolerance complaints triggered by primary epiploic appendagitis
    (2019-08-29) Schnedl, Wolfgang J.; Reittner, Pia; Enko, Dietmar; Mangge, Harald
    Primary epiploic appendagitis (PEA) is an uncommon and self-limiting cause of acute or subacute abdominal complaints. The diagnosis of PEA, with its characteristic appearance, is made with computed tomography (CT). This report describes a patient seven months after a CT-confirmed diagnosis of PEA. Because of persistent and recurring, functional, non-specific abdominal complaints, food intolerance/malabsorption was investigated. Fructose malabsorption combined with histamine intolerance was found. A registered dietician helped develop an individually-tailored diet to address the problem. Within four days of beginning the fructose-free and histamine-reduced diet, the patient’s complaints resolved. In conclusion, abdominal symptoms caused by fructose malabsorption and histamine intolerance may have been triggered by PAE in this patient.
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    Successful palliative peptide receptor radionuclide therapy for impending compression of vena cava due to unresectable liver metastasis of neuroendocrine tumor
    (2019-05-21) Ataeinia, Bahar; Loberg, Christina; Kravets, Hanna; Beheshti, Mohsen; von Mallek, Dirk; Mottaghy, Felix M.; Heinzel, Alexander
    We present the case of a 77 year old male patient with metastatic pancreatic neuroendocrine tumor (NET). The patient was initially treated by extensive surgical resection that however, led to severe complications with delayed recovery. During follow-up, a number of new liver metastases were detected, one of which was in segment I with impending compression of the inferior vena cava. Due to age and general condition of the patient, instead of further surgical treatment, the patient received four cycles of 177Lu-DOTATOC resulting in an overall partial response with successful tumor reduction in liver segment I, resolving an impending compression of vena cava.
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    Traumatic transnasal penetrating injury with cerebral spinal fluid leak
    (2019-04-08) Teng, Tan Sui; Ishak, Noor Liza; Subha, Sethu Thakachy; Bakar, Saraiza Abu
    CSF leak in penetrating skull base injury is relatively rare compared to close head injury involving skull base fracture. We report a 5-year-old boy presented with epistaxis and impacted pencil into the left nostril. The child was hemodynamically stable without any neurological deficit. Intraoperatively, there was a nasal septal defect posteriorly with anterior skull base fracture associated with CSF leak. The pencil was removed from the left nostril and the CSF leak was repaired using harvested abdominal fat under the same setting. Computed Tomography (CT) of the brain showed right cribriform plate fracture with small pneumocranium. Postoperatively, a prophylactic antibiotic was given for seven days and he was discharged well. Subsequent clinic visits up to one-year postoperative period showed no recurrence of the CSF leak. History taking, physical examination and CT imaging give valuable diagnostic values in managing the penetrating skull base injury. Early intervention for removal of the foreign body and repair of the CSF leak is advocated to prevent catastrophic complication.