1.Unicentric Castleman Disease: An Unusual Cause of An Isolated Neck Mass
Anjay Kumar ; Krittika Aggarwal ; Himanshu Agrawal ; Sonal Sharma ; Pankaj Kumar Garg
Malaysian Journal of Medical Sciences 2016;23(4):86-89
Castleman disease (CD) is a rare lymphoproliferative disorder of unknown aetiology. It
manifests in two distinct clinical presentations: unicentric and multicentric. Unicentric CD is rare
and may present as an isolated neck mass. A 22-year-old man presented with a 6-month history
of right neck swelling that occupied the posterior triangle of the right neck region. After surgical
exploration, a solitary, well defined, and hyper vascular mass was excise. A histopathological
examination confirmed the lesion as CD, hyaline-vascular variant. CD of the neck is a diagnosis
that is usually not taken into consideration while evaluating neck masses due to its rarity and
unassuming presentation. It should be keep in the differential diagnosis of neck masses as the
clinical and radiological features evade a firm diagnosis. The treatment of unicentric CD is
complete surgical excision, which cures the patient.
2.An unusual etiology of plummer-Vinson syndrome.
Ankur JAIN ; Parimal AGRAWAL ; Pankaj MALHOTRA ; Ritambhra NADA ; Subhash VARMA
Blood Research 2018;53(1):79-81
No abstract available.
Plummer-Vinson Syndrome*
3.Hoffa fracture associated with femoral shaft and proximal tibial fractures: report of two cases.
Anuj JAIN ; Prakash AGRAWAL ; Manish CHADHA ; Amite PANKAJ
Chinese Journal of Traumatology 2012;15(6):367-369
Solitary coronal shear fractures of femoral condyle, such as Hoffa's fracture, are usually associated with supracondylar or intercondylar fractures of the femur. These fractures are rare and seen in the context of high energy mechanism leading to multiple injuries; therefore a thorough workup of the patient is required to rule out other significant injuries. Hoffa's fracture associated with femoral shaft and proximal tibial fractures is extremely rare and no such injury has been reported previously. We report two such cases which were managed with standard operative fixation techniques and demonstrated good to excellent functional outcome after a follow-up of one year. This report emphasizes that high index of suspicion is required for di- agnosis of these injuries and a thorough workup is mandatory to rule out other associated injuries. We also propose a possible mechanism of injury.
Adolescent
;
Adult
;
Femoral Fractures
;
diagnosis
;
surgery
;
Fracture Fixation, Internal
;
methods
;
Humans
;
Male
;
Multiple Trauma
;
diagnosis
;
surgery
;
Tibial Fractures
;
diagnosis
;
surgery
5.Pituitary apoplexy in an adolescent male with macroprolactinoma presenting as middle cerebral artery territory infarction
Pankaj AGRAWAL ; Sally NEWBOLD ; Ayisha Al BUSAIDI ; Ritika R KAPOOR ; Nick THOMAS ; Simon JB AYLWIN ; Charles R BUCHANAN ; Ved Bhushan ARYA
Annals of Pediatric Endocrinology & Metabolism 2022;27(4):320-324
Pituitary apoplexy typically presents with acute headache, vomiting, visual disturbance, and confusion. Herein, we report a rare presentation of ischemic stroke due to pituitary apoplexy. A 16.5-year-old male presented with reduced Glasgow Coma Scale (GCS) score, slurred speech, right-sided hemiparesis, and bitemporal hemianopia. Magnetic resonance imaging of the brain showed a large hemorrhagic sellar/suprasellar mass and an area of cortical T2/FLAIR hyperintensity with corresponding diffusion restriction in the middle cerebral artery territory. Computed tomography (CT) intracranial angiogram showed luminal occlusion of the clinoid and ophthalmic segments of both internal carotid arteries (ICAs, left>right) due to mass pressure effect. Biochemical investigations confirmed hyperprolactinemia and multiple pituitary hormone deficiencies. Stress-dose hydrocortisone was commenced with cabergoline, followed by urgent endoscopic transsphenoidal debulking of the tumor (subsequent histology showing prolactinoma). Postoperative CT angiogram showed improved caliber of ICAs. Intensive neurorehabilitation was implemented and resulted in complete recovery of motor and cognitive deficits. At the last assessment (18.8 years), the patient remained on complete anterior pituitary hormone replacement without cabergoline. Pituitary apoplexy is a medical emergency requiring prompt recognition and treatment and should be suspected in patients presenting with sudden, severe headache; nausea; or visual disturbance and meningism. Ischemic stroke is a rare manifestation of pituitary apoplexy in the pediatric population.