Year 2023, Volume 7 - Issue 4

Open access Case Report | March 24, 2023
Unusual presentation of classical Kaposi Sarcoma: penile involvement in an HIV sero-negative patient
Ugur Aferin , Berin Selcuk , Cansu Turker , Ovgu Aydin Ulgen , Hamdi Ozkara
Year: 2023 | Pages: 75 - 78
Background: Kaposi's sarcoma (KS) is a multifocal, angioproliferative malignant lesion originating from lymphatic endothelial cells. KS limited to the penis is extremely rare in human immunodeficiency virus (HIV) sero-negative patients. In this study, we aimed to present a case of isolated primary penile KS unrelated to HIV. Case Presentation: A 65-year-old man, with no risk factors for KS, presented with reddish nodules on penis. Biopsy was recommended to the patient for definitive diagnosis. Histopathological examination revealed that the diagnosis was classical type KS. No distant metastases were detected. No recurrence or disease progression was detected during the 4-year follow-up. Conclusion: Isolated primary penile KS is extremely rare in HIV sero-negative patients, but it should be kept in mind in the differential diagnosis of pigmented and nodular lesions in the penis. Excision of lesions with negative surgical margins has a high success and very low complication rate, as in our case.

Open access Case Report | April 11, 2023
Chylothorax, central venous thrombosis and pulmonary infarct in a patient of ovarian germ cell tumor: a case report
Abhishek Sharma , Itishree Singh , Sarvinder Singh , Anvesh Rathore , Puneet Saxena , Anuradha Ahuja
Year: 2023 | Pages: 79 - 82
Background: Extra-abdominal presentations are rarely seen in ovarian germ cell tumors (OGCT). We report a case of a patient with OGCT who presented with systemic venous thrombosis, pulmonary infarct, and chylothorax simultaneously. Case Presentation: A 13-year-old girl presented with dyspnea, fever, and cough of 1 week duration. She was detected to have left-sided chylothorax. Carcinoma Antigen 125 and alpha fetoprotein levels were raised. Computed tomography showed a large ovarian mass, and thrombi in superior vena cava, left brachiocephalic vein, and segmental branch of right pulmonary artery. She also had a peripheral opacity in the right lung with a reverse-halo sign, suggestive of pulmonary infarct. She was diagnosed with yolk-sac tumor and managed with anticoagulation and subsequently neo-adjuvant chemotherapy and surgery. Conclusion: Prothrombotic state in OGCT can lead to systemic thrombosis which may result in chylothorax due to obstruction of thoracic duct. The phenomenon, though rare, should be kept in mind during management of OGCT.

Open access Case Report | March 28, 2023
Two case reports of sudden cardiac arrest with unsuccessful resuscitation: is there a role for postmortem investigation and targeted next generation sequencing?
Maaike Ramael , Hilde Van Steelandt , Marc Ramael
Year: 2023 | Pages: 83 - 88
Background: Sudden unexpected cardiac arrest is one of the life-threatening interventions of the pre hospital emergency medicine teams. Globally sudden cardiac death (SCD) accounts for 4-5 million deaths per year and is in most cases linked to coronary artery disease. Other causes include cardiomyopathies and channelopathies, but these are not always clear to the physician. Case Presentation: We present two unconscious patients with life-threatening cardiac arrests who were unsuccessfully resuscitated by the emergency team. As the cause of the sudden cardiac arrest was unclear an autopsy was performed. Conclusion: SCD can be the final stage of several pathologies. In acute myocardial infarction due to coronary artery disease, the underlying cause is clear. The situation is however more complex in drug abuse where the physician should be aware that underlying pathologies can be masked. If the cause of sudden cardiac arrest is unclear, a "molecular" autopsy is recommended to detect genetic susceptibility to dysrhythmias( long QT syndrome, Brugada syndrome), cardiomyopathies, thoracic aortic aneurysm, and dissection. Correlating significant clinical information, postmortem findings and genetic analysis can be used to detect underlying pathologies and to decide whether genetic screening and clinical follow up of relatives should be carried out.

Open access Case Report | April 08, 2023
Calcinosis cutis in a patient with severe COVID-19 infection
Amna Zahid , Lucy Smith , Arsalan Sheikh , Naveen Sharma , Maria Konstantopoulou
Year: 2023 | Pages: 89 - 91
Background: Atypical presentation of calcinosis cutis in the context of COVID-19 infection complicated by acute renal failure has not been described in literature. We report a case of severe COVID-19 infection and its associated uncommon skin manifestation. It is a rare condition and its association with different diseases has been established in the past. However, to the authors' knowledge, calcinosis cutis has not yet been described in relation to COVID-19 infection complicated by acute renal failure. Case Presentation: Here we describe a case of a 55-year-old gentleman admitted to the intensive care unit with severe COVID-19 infection whose hospital stay was complicated by acute renal failure and development of hypocalcemia which was treated with oral and intravenous calcium. Subsequently, he developed an atypical fleshy lesion on his left ankle during his in-patient stay which was histologically proven calcinosis cutis. It was successfully treated with topical medications. Conclusion: This case highlights the importance of considering a wide differential of skin lesions including calcinosis cutis in patients who are critically unwell with COVID-19 or any other severe infections and develop isolated skin lesions in the setting of impaired renal functions and abnormal calcium phosphate metabolism with calcium administration.

Open access Case Report | March 30, 2023
Intermediate malignant peritoneal mesothelioma: a rare clinical case report
Valentina Iori , Francesco Calabrese , Giorgio Querini , Matteo Magnoli , Greta Bortolin , Maurizio Muscara , Leonardo Iannuzzelli , Sandro Zonta
Year: 2023 | Pages: 92 - 95
Background: Multicystic peritoneal mesothelioma (MCPM) is an uncommon mesothelium-related neoplasm, representing 3%-5% of peritoneal mesotheliomas. The annual incidence rate is 2 per 1,000,000. Typically, it is discovered unintentionally and accompanied by subacute abdominal pain. Surgery is the initial treatment option and involves the removal of cysts entirely from the body. In our case we describe an uncommon clinical and radiological presentation of this rare clinical entity. Case Presentation: We present the case of a 48-year-old male who presented with severe abdominal pain. The computed tomography scan of the abdomen revealed a septate pluriconcameral oval formation, hyperdense, suprahydric density content. The patient underwent exploratory laparoscopy. Numerous cystic structures were discovered. A histopathological examination revealed the MCPM. The patient was discharged and pursued follow-up at a specialized center. Conclusion: MPCM is a neoplasm whose pathophysiology is yet unknown, due to the lack of longitudinal studies and its rarity. Further studies are necessary to improve the treatment and management of the patients.