Cases reported "Recurrence"

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21/244. zygomycosis in relapsed acute leukaemia.

    We would like to report the use of liposomal amphotericin in eradicating mucormycosis in two patients who had relapsed acute leukaemia. The first patient with relapsed acute myeloid leukaemia developed a rapidly expanding solitary necrotic neck lesion associated with opacity of maxilliary sinus at a time when he was profoundly pancytopenic following high dose chemotherapy. The second patient was a 3-year-old boy with pre-B acute lymphoblastic leukaemia who developed a central nervous system relapse whilst on his first line treatment and was treated with more aggressive chemotherapy on the Medical research Council Relapse Protocol. During a period of profound pancytopenia following re-induction therapy, including high dose steroids and prolonged course of antibiotics for proven septicaemia, he developed periorbital swelling and proptosis and a clinical diagnosis of rhinocerebral mucormycosis was made. Both patients were treated with high doses of liposomal amphotericin (Ambisome Nexstar). The doses were escalated to 10 and 15 mg/kg/day, resulting in successful eradication of the mucormycosis.
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22/244. dyspareunia and recurrent stress urinary incontinence after laparoscopic colposuspension with mesh and staples. A case report.

    BACKGROUND: A laparoscopic colposuspension technique using hernia staples and polypropylene mesh has been introduced for the treatment of stress urinary incontinence but is not without hazards. CASE: A 32-year-old woman developed recurrent stress urinary incontinence and dyspareunia approximately one year after undergoing laparoscopic colposuspension with hernia staples and polypropylene mesh. Metal staples palpated vaginally corresponded with the area of maximal tenderness, and the bladder neck was hypermobile. Upon surgical exploration of the space of Retzius, four staples were found in the bladder wall, and polypropylene mesh densely adherent to the bladder wall had eroded into the muscularis. CONCLUSION: Laparoscopic colposuspension with hernia staples and polypropylene mesh may be associated with early recurrence of incontinence and dyspareunia.
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23/244. Microcystic adnexal carcinoma associated with primary immunodeficiency, recurrent diffuse herpes simplex virus infection, and cutaneous T-cell lymphoma.

    Cutaneous microcystic adnexal carcinoma (MAC) is a rare and poorly understood tumor that predominantly occurs in the head and neck. MAC usually affects people in their fourth and fifth decades. Some patients have had a history of radiation. We present a case of MAC occurring in the left antecubital fossa of an 18-year-old white woman with an unusual immunodeficiency syndrome. The patient also developed a squamous cell carcinoma, a cutaneous T-cell malignancy, and a perigastric leiomyoma. A congenital infection of herpes simplex virus (HSV) persisted throughout her life. The association of HSV infection with MAC and squamous cell carcinoma and that of peripheral T-cell lymphoma with Epstein-Barr virus is discussed in relation to her immunodeficiency.
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24/244. actinomycosis of the frontal and parotid regions.

    Cervicofacial actinomycosis still occurs infrequently and should be included in the differential diagnosis of neoplasms, and chronic suppurative and granulomatous lesions of the head and neck region. The authors present two cases of actinomycosis. Patient 1 was a 32-year-old man who was first seen with a firm, suppurative mass at his left frontal region. Patient 2 was a 36-year-old woman with an indurated mass at her left parotid area. Both patients were diagnosed histopathologically with cervicofacial actinomycosis, but each patient had a different clinical course and different response to antimicrobial and surgical treatments.
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25/244. Cervical tumor by ectopic salivary gland.

    Heterotopic salivary tissue is a rare lesion, although most authors agree that anomalous embryologic development of salivary tissue is the main cause. One case of cervical tumor by ectopic salivary gland is reported, and existent literature is reviewed. A 26-year-old woman was operated on for a cystic tumor in the midline of the neck diagnosed as thyroglossal cyst in the hyoid region. After Sistrunk operation, the recurrence was immediate. A second operation was performed, and a solid tumor located between muscles of the tongue was resected. A long tract opening in recurrent cervical cystic tumor was also removed. No recurrence was evident at 1 year after surgery. Pathological examination of the excised mass revealed an ectopic salivary gland with serous and mucinous acini located between muscles of the tongue. This is a rare case report of a cervical fistula by ectopic salivary gland surrounded by muscles of the tongue draining into a cystic tumor in the hyoid midline lesion. recurrence of thyroglossal cyst after a correct surgical resection must be suspected as an ectopic salivary tissue. Also when a cystic neck tumor is present, an ectopic salivary gland must be suspected.
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26/244. role of radio-guided surgery in recurrent secondary hyperparathyroidism.

    BACKGROUND: The aim of this paper is to state the role of radio-guided surgery (RGS) in case of recurrent secondary hyperparathyroidism. methods: Two cases of recurrent secondary hyperparathyroidism were treated using RGS. After a preoperative assessment, which included ultrasonography (US), MRI and (99m)Tc-radiolabelled sestamibi scan, a radio-guided neck re-exploration was planned. On the day of surgery the patients underwent a radionuclide injection. After 90 min, surgery began. RESULTS: dissection was guided by placing the probe in the wound to localize any increased concentration of radioactivity. In the first case the probe identified the gland located deeply in the right tracheo-esophageal groove; in the other case the probe detected a site of increased uptake in the upper mediastinum. Both lesions were dissected and excised; a frozen section confirmed they were parathyroid glands with diffuse hyperplasia. The operative time was less than 60 min in both cases. The patients were discharged on the first postoperative day. A decrease in serum calcium and PTH was observed subsequently. A minimum follow-up of 6 months did not show any recurrence. CONCLUSION: RGS can help in detecting the parathyroid tissue in selected cases of renal hyperparathyroidism and makes operation much easier and more predictable.
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27/244. Assessment and management of polymyalgia rheumatica in older adults.

    polymyalgia rheumatica (PMR) is a periarticular rheumatic condition characterized by pain and stiffness, primarily in the neck, shoulders, hips, and pelvic girdle. Temporal arteritis (TA) or giant cell arteritis, the most common primary vasculitis in older adults, is found in approximately 10% to 30% of people who have PMR. Left untreated, TA can result in sudden, irreversible blindness. Geriatric nurses need to familiarize themselves with these disorders to accurately assess and manage people with them.
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28/244. Hematogenous pyogenic facet joint infection of the subaxial cervical spine. A report of two cases and review of the literature.

    Two cases of hematogenous, pyogenic, subaxial cervical facet joint infection are reported, and the literature is reviewed. infection of the cervical facet joint is a rarely diagnosed condition; only one case has been reported in the literature. Lumbar facet joint infections are also rare but more commonly reported. Approximately one fourth of facet joint infections in the lumbar spine are complicated by epidural abscess formation, which can lead to a neurological deficit. Because of the paucity of reports on cervical facet joint infections, the clinical characteristics of this entity are not well known. Both patients presented with an acute onset of unilateral neck pain that radiated into the ipsilateral shoulder. Frank radicular pain was initially absent. Unilateral upper-extremity motor weakness that was attributed to associated epidural abscess or granulation tissue formation was also demonstrated in both patients. leukocyte count and erythrocyte sedimentation rate were elevated in both cases. magnetic resonance imaging was necessary to obtain an accurate diagnosis. staphylococcus aureus was identified as the offending pathogen in both cases. Decompressive surgery and antibiotic therapy were required to cure the condition. One patient recovered completely and the other sustained a permanent motor deficit. Hematogenous cervical facet joint infection is a rare clinical entity that has many characteristics in common with the more-common lumbar homolog. All three reported cases, however, have been complicated by epidural abscess or granulation tissue formation that has led to a neurological deficit. This finding suggests that a facet joint infection in the cervical spine may have a less benign clinical course than that in the lumbar spine.
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keywords = neck
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29/244. Intracranial adenoid cystic carcinoma of suprasellar region.

    Adenoid cystic carcinoma (ACC) is a relatively common head and neck tumor which grows slowly but locally aggressive and prone to recurrence. ACC most commonly arises in the major and minor salivary glands. Some rare cases of intracranial ACC with an unknown primary site have been reported. The authors present the first case of primary intracranial ACC of the suprasellar region. A 34 year-old female presented with one month's duration of visual disturbance and galactorrhea. Magnetic resonance image (MRI) showed intra- and suprasellar mass mimicking a craniopharyngioma. There was no evidence of invasion from an extracranial site. The operative findings showed the mass existed under the arachnoid membrane and seemed to originate from the pituitary stalk. Pathological diagnosis was ACC. After the first operation, local recurrence and CSF dissemination to the lower clivus occurred within two months. recurrence repeatedly treated by Gamma knife radiosurgery 10 times and 4 times by surgery during a 3 year follow-up period. But total removal of the tumor at the first operation along with radiosurgery may control the lesion and prevent further recurrence.
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30/244. An unusual post-traumatic occipitocervical pseudomeningocele: case report.

    BACKGROUND: A rare case of massive post-traumatic subcutaneous pseudomeningocele probably communicating with the cisterna magna, is reported. CASE DESCRIPTION: An 8-year-old boy sustained a severe injury to the nape of the neck, after which he developed a huge local subcutaneous swelling containing cerebrospinal fluid (CSF). communication of the subcutaneous CSF collection with the cisterna magna or any other site of dural fistula could not be identified. After a lumbo-peritoneal CSF shunt, the swelling resolved completely. CONCLUSION: The clinical features of a rare case of symptomatic post-traumatic cerebrospinal fluid pseudomeningocele are elaborated.
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