Cases reported "Lithiasis"

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1/11. Antrolithiasis in the frontal sinus.

    A very rare case of sinusitis with antrolithiasis in the left frontal sinus of a 63-year-old male patient is reported. Various conservative treatments had no effect on the decrease of his left frontal pain and of postnasal drip. Neither bacteria nor fungus were detected in the discharge. Computed tomographic scanning revealed several high-dense spots in an isodense shadow in the left frontal sinus. At first, endoscopic sinus surgery (ESS) was employed and a stony mass was detected in the nasofrontal duct and sinus. Patency of the nasofrontal duct was insured and a sticky paste and small masses were removed as well as possible. However, the flow of discharge from the frontal duct continued after surgery. We performed a second operation with extranasal approach and additional stones in the sinus were successfully removed. Most cases of antrolithiasis are caused by a foreign body or caseous sinusitis with fungus. The maxillary sinus is the most common site of disease in antrolithiasis. It is unknown why the present case of antrolithiasis was in the frontal sinus. In such cases of antrolithiasis or cases having pastelike contents in the frontal sinuses, we conclude that ESS may be an unsuccessful treatment and a classical surgical approach may be required.
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2/11. All that wheezes is not asthma--broncholithiasis, a forgotten disease.

    INTRODUCTION: asthma is a common condition seen by medical practitioners. However, 'all that wheezes is not asthma', is an important adage not to be forgotten. We report a case of broncholithiasis which was initially misdiagnosed as asthma. CLINICAL PICTURE: An 81-year-old female presented with cough and intermittent wheezing associated with one episode of haemoptysis. Chest radiograph and CT thorax were suggestive of broncholithiasis. This was confirmed by flexible bronchoscopy. TREATMENT: The broncholith was successfully extracted using flexible bronchoscopy. OUTCOME: The patient had complete resolution of symptoms post procedure. CONCLUSIONS: physicians should always entertain other differential diagnoses which may mimic asthma.
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3/11. Pulmonary alveolar microlithiasis in childhood: clinical and radiological follow-up.

    This report describes a case of pulmonary alveolar microlithiasis that was diagnosed in an 8.5-year-old girl by high-resolution computed tomography (CT) and open lung biopsy. Presence of symptoms (productive cough, fever), their periodic occurrence (lasting up to 1 week), and comparatively long asymptomatic periods should be emphasized. Despite extensive X-ray abnormalities, tests of pulmonary interstitium involvement and exercise tests revealed normal results. A therapeutic regimen, including disodium etidronate, was administered for 18 months with no significant clinical or radiological improvement.
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4/11. Hematospermia (ejaculatory duct calculus)--an unusual cause.

    Hematospermia is a common harmless condition that invokes a lot of anxiety to the patient. Calculous obstruction of the ejaculatory duct is an unusual cause of hematospermia. We report one such case of hemospermia due to an ejaculatory duct calculus that was diagnosed with TRUS. An endoscopic approach should be attempted to manage all such cases.
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5/11. Extremely well-differentiated adenocarcinoma of the gastric cardia: a unique case with columnar cells and laminated stones.

    Extremely well-differentiated adenocarcinoma (EWDA) is an unusual gastric cancer that is histologically too bland to be diagnosed as malignant neoplasm, particularly using biopsy. EWDA may be a gastric counterpart of 'adenoma malignum' or minimal deviation adenocarcinoma (MDA) in the uterine cervix; however, the clinicopathological features of EWDA remain less apparent than those of MDA. A 60-year-old male was complaining of dysphagia. He had been made aware of a small submucosal tumor in the cardia 2 years before the onset of this symptom. Endoscopic ultrasonographic examination revealed a large cardiac tumor consisting of thickened layers, as observed in Borrmann type IV. Three mucosal biopsies suggested only benign changes including adenoma and hyperplastic polyps. At the fourth biopsy, cytologically bland columnar cells were located in the submucosa along with stromal fibrosis and laminated stones. The possibility that non-neoplastic aberrant pancreas with lithiasis formed the tumor was denied at laparotomy by a frozen section that revealed benign-looking glands invading the diaphragm. Immunohistochemically the cancer glands were positive for CA19-9 and human gastric mucin, but not for p53 or MUC2. To our knowledge, this is a previously unknown combination of EWDA and psammomatous calcification in the stomach.
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6/11. Rhinolithiasis: a very late complication after dacryocystorhinostomy with rubber-gum and polyethylene stenting.

    PURPOSE: To describe a rare case of rhinolith formation 21 years after dacryocystorhinostomy (DCR) with rubber gum and polyethylene tubing surgery. DESIGN: Interventional case report. methods: A 23-year-old-woman underwent uneventful left DCR with rubber gum and polyethylene tubing for chronic dacryocystitis. Twenty-one years later, she presented with purulent rhinorrhea, nasal obstruction, and facial pain. Computed tomography revealed a radiopaque density in the left nasal cavity. RESULTS: A rubber gum foreign body embedded with granulation tissue and a huge rhinolith was removed endoscopically through the anterior nares. After surgery, the patient reported immediate and complete relief of symptoms. CONCLUSION: Rhinoliths can develop progressively several years after DCR as a result of foreign body reaction to rubber gum or polyethylene tubing. This rare complication should be ruled out in patients complaining of purulent rhinorrhea who underwent DCR with tubing before the early 1980s.
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7/11. Biliary lithiasis in early pregnancy and abnormal development of facial and distal limb bones (Binder syndrome): a possible role for vitamin k deficiency.

    BACKGROUND: Binder syndrome is a maxillonasal dysostosis characterized by midface and nasal hypoplasia, sometimes associated with short terminal phalanges of fingers and toes and transient radiological features of chondrodysplasia punctata. warfarin- or phenytoin-induced vitamin k deficiency during early pregnancy is a well-established etiology for this syndrome, which occurs nevertheless sporadically in most cases. CASE(S): We describe here the first case, to our knowledge, of Binder syndrome in a child whose mother presented with biliary lithiasis in early pregnancy. The mother proved to have a decrease in clotting factors II, VII, and X, and in prothrombin time, at 11 weeks of gestation, which was highly suggestive of vitamin k deficiency. CONCLUSIONS: The biliary lithiasis-induced vitamin k deficiency in early pregnancy is likely to have resulted in Binder syndrome. This observation should prompt physicians to carefully check for vitamin k deficiency in pregnant women presenting with biliary lithiasis, in order to prevent Binder syndrome in the fetus by providing intravenous vitamin K supplementation as soon as possible. Finally, reassuring genetic counseling regarding the genetic risk for future pregnancies is to be provided to the parents.
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8/11. A newly recognised cause of vertigo: horizontal canal variant of benign positional vertigo.

    AIMS: To describe the presentation, causes, treatment, and outcomes of patients presenting with the newly recognised horizontal canal variant of benign positional vertigo (BPV); and to emphasise the importance of performing a positional test on all patients being assessed for vertigo. methods: The records on 400 patients presenting with BPV were analysed. Two detailed patient histories from 2004 are included. RESULTS: Forty-nine patients (12%) had horizontal canal BPV. The median presentation age was 59 years. In 17 patients, it presented de novo during repositioning treatment for 'classical' posterior canal BPV. Repositioning is in the horizontal plane, with the direction depending on whether the mechanism is canalithiasis or cupulolithiasis. CONCLUSIONS: Horizontal canal BPV explains nearly all variations on 'classical' (posterior canal) BPV. It accounts for at least 10% of BPV and has been frequently misdiagnosed. Repositioning is usually curative if the symptomatic ear is correctly identified.
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keywords = nose
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9/11. Rhinolithiasis as cause of oronasal fistula.

    Rhinolithiasis is a disease caused by deposition of organic and inorganic compounds in the nasal cavity, leading to unilateral nasal obstruction, fetid rhinorrhea, epistaxis, and it may cause complications. The authors present a case of rhinolithiasis with oronasal fistula and literature review.
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10/11. Rhinolithiasis: an uncommon entity of the nasal cavity.

    Rhinoliths are uncommon foreign bodies of the nose formed by in situ calcification of intranasal endogenous or exogenous foreign material. They are often an asymptomatic condition diagnosed accidentally during a routine examination. Although nasal foreign bodies are more frequently seen in children, and appear to be more common in women, they have been reported in patients of all ages. This article describes a case of rhinolith involving a 38-year-old male. The etiology, thin-sectioned microscopic findings, differential diagnoses, and treatment are also discussed.
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keywords = nasal, nose
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