Year 2023, Volume 7 - Issue 8

Background: Mycosis fungoides (MF) represents the most common cutaneous T-cell lymphoma and approximately 4% of non-Hodgkin lymphomas. Treatment of skin lesions includes external beam radiation therapy which often provides adequate local control and symptom relief. Case presentation: A 39-year-old male with the diagnosis of MF presents with infiltrative and pruriginous plaques comprising the plantar, interdigital, lateral and posterior surfaces of the foot. A protocol using a water tank was used to provide uniform coverage to an irregular target volume. By creating a tissue-equivalent and homogenous bolus material a total dose of 8Gy in 2 fractions of photon-beam therapy was prescribed. After one month of treatment there was a partial response with minimal toxicity, achieving complete response in most lesions after six months. Conclusion: Photon-beam therapy for irregular surfaces such as extremities is a valid alternative to conventional electron-beam radiation by attaining uniform coverage while minimizing hotspots. Treatment utilizing a water tank is well-tolerated and has good clinical outcomes even in the presence of extensive skin lesions.

Background: As surfing gains adherents, the injuries derived from its practice become more frequent, one of which is the so-called surfer's myelopathy. Case presentation: We present the case of a patient with an abrupt onset of mild back-lumbar pain, followed by paresthesia and motor involvement of both lower limbs as well as sphincter disturbance in the context of the immediate practice of an aquatic sport. Thoracic spinal cord MRI showed T2 hyperintensities in the central part of the spinal cord between T8-T12. Surfer's myelopathy is a nontraumatic spinal cord injury, of vascular etiology, caused by the prolonged hyperextension of the spine. Conclusion: The importance of this work lies in being one of the few in Peru addressing this pathology and the need of awareness for taking preventive measures by young athletes.

Background: Malignant peripheral nerve sheath tumor (MPNST) is a rare variety of soft 10-tissue sarcoma of ectomesenchymal origin. It represents approximately 10% of all soft tissue sarcomas. Though these tumors due to their Schwann cell origin may occur anywhere near a nerve trunk, breast is a rare site of its occurrence. This is a rare case of MPNST arising in the breast and not associated with neurofibromatosis type 1.
Case Presentation: A 22-year-old female presented with a large painless breast lump for 5 months, which was clinically suspected to be a Carcinoma. No confirmatory results were 18 obtained with fine needle aspiration biopsy , core biopsy, and magnetic resonance imaging. Wide local excision was done. Histopathology and immunohistochemistry confirmed MPNST. Furthermore, she underwent adjuvant radiation to her breast.
Conclusion: The unusual location and size of the tumor make our study noteworthy. Owing to the infrequent occurrence of the tumor, there are no definite guidelines for its management. We recommend wide local excision with postop radiotherapy as the optimum treatment for this condition.

Background: Lesions characterized by myeloma are lytic lesions surrounded by sclerosis. Diffuse or wide-length sclerotic bone lesions associated with myeloma are infrequent. Case presentation: Two men, 70 and 72 years old, were referred from oncology to hematology for diffuse, large-length sclerotic bone lesions. Their findings were interpreted as having bone metastasis of primary cancer in orthopedics, internal medicine, and oncology due to diffuse sclerotic bone lesions found incidentally during the examinations performed for another reason. The probable causes (prostate, lung, and gastrointestinal cancer) of metastasis were investigated, and they were referred to hematology after a nearly 2-month examination period. Conclusion: The remarkable extensive sclerotic bone lesions may mask the myeloma and may not be considered in the differential diagnosis. However, these cases had the typical clinical findings and laboratory results of MM, except for bone disease. Therefore, we aimed to highlight this issue.

Abstract Background: In the acute context, spontaneous hemopneumothorax is a potentially life-threatening condition that can occur without any radiological abnormalities and may be caused by thoracic vascular aberrancy. Case presentation: We discuss the case of a healthy 24-year-old man who visited our emergency department complaining of left sided chest pain and shortness of breath. He had previously visited a tertiary care facility's emergency department for the same complaint the same day and had been released following a normal CXR and blood tests. His repeat CXR revealed hemopneumothorax in our department. His CT scan further revealed ruptured aberrant blood vessel which was medial to the left subclavian artery. Conclusion: This example case report illustrates the importance of maintaining a high index of suspicion for the probability of haemo or pneumothorax when evaluating patients who present with chest pain and shortness of breath. There must be a repeat patient examination and CXR for patients who experience prolonged chest discomfort, despite normal initial investigations. If the patient's repeat x-rays indicate hemopneumothorax, this should leave one to ponder the likelihood that thoracic bleeding could result from vascular aberrancy. Keywords: chest pain, spontaneous hemopneumothorax, case report, thoracotomy and Chest X-ray.