Year 2022, Volume 6 - Issue 4

Background: Patients with Cushing's syndrome have an increased risk of thrombosis due to acquired hypercoagulability. Case Presentation: A 54-year-old obese female, with underlying iatrogenic Cushing's syndrome (ICS), presented with a sudden onset of dyspnea and circulatory collapse. Computed tomography pulmonary angiogram confirmed acute massive pulmonary embolism (PE). She showed marked improvement after treatment with anticoagulation. Conclusion: This case demonstrates the clinical presentations and pathophysiology of Cushing's syndrome (CS). CS patients are prone to thrombosis due to disturbance in all three components of Virchow's triad. PE is one of the leading causes of mortality in CS. Clinicians should be aware of this serious, but less recognized, complication when a patient with CS presents with acute circulatory collapse. Anticoagulants remain the mainstay of treatment in ICS complicated by PE.

Background: Drug rash with eosinophilia and systemic symptoms (DRESS) syndrome is a rare idiosyncratic and unpredictable drug reaction most commonly attributed to anticonvulsants, allopurinol, and antibiotics. Fever in combination with cutaneous manifestations and eosinophilia are the cardinal clinical findings, while organ involvement and very rarely pancytopenia can be present. Case presentation: We describe a 26-year-old female patient with pancytopenia in the context of lamotrigine-induced DRESS and we summarize this as a potentially life-threatening hypersensitivity reaction. Conclusion: DRESS should be suspected in patients presenting with fever, eosinophilia, skin involvement, and/or visceral organ involvement, who have started a new drug during the past 2 to 6 weeks, as early recognition of this syndrome with subsequent discontinuation of the offending drug could be lifesaving.

Background: Primary cardiac tumors originating in the heart are much less frequent than metastasis from other organs. The majority of cardiac tumors are of benign nature and only 25% are estimated to be malignant. Common symptoms of cardiac tumors include systemic embolization, congestive heart failure, and arrhythmias. Case report: We present two cases of cardiac tumors initially causing heart failure symptoms and valvular disease in relatively young patients. These tumors were initially diagnosed as myxomas, but post-op histological studies revealed the presence of angiosarcoma and hamartoma. It is important to differentiate and have a clear diagnosis because some malignant and invading tumors may require the use of adjuvant chemotherapy agents. Conclusion: It should not be taken for granted that cardiac tumors are of benign nature even if initial evaluation is consistent with myxomas. Early resection and pathological study of primary cardiac tumors are important in identifying the tumor type and targeting management.

Background: About 1-5% of all anterior cystic neck masses account for parathyroid cysts, which can be functional and nonfunctional. Functional cyst or cystic parathyroid adenoma is a very rare tumor which causes primary hyperparathyroidism and relatively hypercalcemia. Here, we present a giant cystic parathyroid adenoma which is the largest reported to date in the literature. Case Presentation: Our patient presented with a right-sided neck mass and manifesting symptoms, which developed recently, such as itching, fatigue, proximal muscle weakness, and polyuria. In this case, the high calcium level had not been taken into account when evaluating the patient; the possibility of parathyroid adenoma had not been suspected; and repeated aspirations had been performed. After parathyroidectomy, the patient developed postoperative hyperparathyroidism as a complication. Conclusion: Even though cystic parathyroid adenoma is a rare diagnosis, it should be considered in differential diagnosis, and parathyroid hormone of the aspirated fluid from the neck mass should be measured.