Year 2020, Volume 4 - Issue 7

Background: Glomus tumors are benign and rare vascular tumors, with an incidence of less than 2% in relation to all soft tissue tumors. About 75% occur in hand, especially in the nail bed, even though these tumors may also occur in atypical locations. They are characterized by a triad composed of pain, cold intolerance, and point tenderness. Case Presentation: We present a clinical case of a male patient with 67 years old with a painful lesion on the subcutaneous tissue of the knee with 5 years of evolution. The pain exacerbated with the cold. He underwent surgical excision with pain resolution, and no recurrence or metastasis was found at 30-month follow-up. Conclusion: The rapid diagnosis of glomus tumors is important to avoid treatment delays leading to chronic pain. It is important to consider glomus tumors in the differential diagnosis of subcutaneous lesions.

Background: Mesothelioma is a rare malignancy which is uniformly fatal without treatment. The standard of care for peritoneal mesothelioma is currently cytoreductive surgery (CRS) and hyperthermic intraperitoneal chemotherapy (HIPEC). Recurrent disease after treatment is typically confined to the peritoneal cavity. Case Presentation: We present the case of a 34-year-old female with recurrent peritoneal mesothelioma in the left chest wall, 26 months after her initial CRS and HIPEC. The patient underwent excision of the chest wall excision with the removal of the lower ribs, CRS, and HIPEC. Histopathology confirmed epithelioid-type mesothelioma deposits in skeletal muscle and hyaline cartilage. Her recovery was uncomplicated, and she was planned for adjuvant radiotherapy postoperative. Conclusion: This case presents an unusual and rare site of the recurrence of malignant peritoneal mesothelioma. It highlights the difficulty in choosing the optimal management of such cases of recurrence and the role of surgery in these instances. In complex cases of recurrent peritoneal mesothelioma, we recommend a discussion within a multidisciplinary team to provide the optimal outcome for these patients.

Background Drug-induced sleep endoscopy (DISE) is a useful method to evaluate multiobstructive sites simulating sleep with drugs; and propofol is the most widely used sedative for this purpose. Different adverse effects have been reported for propofol, including decrease in ventilatory drive and respiratory depression. Several clinical reports have also suggested a possible excitatory effect on the CNS. The supporting electroencephalographic (EEG) evidence is variable; in some cases, where the EEG has been monitored during the administration of propofol, epileptiform activity is not accompanied by motor manifestations, while in other cases, the EEG recordings after the events are reported as normal. Case presentation A 44-year-old male OSA patient, with negative neurological history, had three close episodes of generalized tonic-clonic seizures during DISE few minutes after sedation with increasing doses of propofol. Polygraphic intraoperative recording with EEG monitoring showed the evidence of epileptiform activity. Conclusion The complete polygraphic intraoperative recording during DISE, inclusive of brain electrical function monitoring, allowed us to record the proconvulsive effect of propofol – a rare but possible adverse event.

Background: Superior mesenteric artery syndrome (SMAS) is a rare cause of duodenal obstruction that has non-specific and insidious symptoms. An initial treatment is conservative, and surgery is reserved for patients who continuously present with symptoms or complications. The aim of this study is to describe a combination of two surgical techniques: duodenojejunostomy and Strong's procedure (the release of the Treitz ligament) through a laparoscopic approach. This combination of both techniques has already been described, however, with a lack of technical detail. Case Presentation: This report presents the case of a 19-year-old male diagnosed with SMAS, confirmed through computed tomography and angiographic magnetic resonance imaging of the abdomen. He underwent a laparoscopic duodenojejunostomy and release of the Treitz's ligament. The patient recovered well with no complications and was discharged 5 days postoperatively. Conclusion: Due to the rarity of the disease, there is a lack of literature comparing the benefits of either of these two techniques, and also, there are no established protocols favoring the use of one procedure over the other. In this case, we combined both techniques to reduce the rate of recurrence, increase the anastomotic safety, and reduce long-term complications. However, a larger study would be necessary to establish the combined use of these two techniques.

Background: Trigeminal neuralgia (TN) is a term used in short-term acute pain in the trigeminal nerve distribution that feels like stabbing or electric shock. Isotretinoin (13-cis-retinoic acid) is a commonly used medication for the treatment of severe cystic acne that does not respond to other therapies. Isotretinoin treatment has been associated with rare but serious complications on multiple systems. Case Presentation: This case report presents a patient who developed TN while using oral isotretinoin therapy for acne vulgaris. This rare adverse event has not been well documented in the medical literature. Conclusion: The author want to emphasize with this case report that physicians should keep in mind that TN is one of the possible negative effects of isotretinoin.

Background: Acute pancreatitis generally leads to complement activation, which mediates tissue injury and inflammatory cascades. Retinopathy associated with pancreatitis is rare but run a rapid course independent of disease activity leading to vision loss. Case Presentation: We present a case of 39-year-old man who had transient blindness associated with acute pancreatitis. Conclusion: This a rare presentation associated with pancreatitis which can lead to complete vision loss if left undetected and untreated.