Year 2024, Volume 8 - Issue 5

Background: Inflammatory, hemorrhagic or tumoral laryngeal mass lesions can be found, but some of these lesions can be very rare, which makes the diagnosis a real challenge. Case presentation: We report a case of a laryngeal/hypopharynx lesion in a 69-year-old man with a submucosal bulging in the right piriform sinus. The only notable symptom was a mild foreign body sensation. CT scan confirms the presence of an expansive lesion, with lobulated contours, cystic/ with necrosis, comprising the right lateral wall of the hypopharynx, involving the piriform sinus circumferentially. Differential diagnosis with schwannoma, paraganglioma, hemangioma or other rare laryngeal lesions has to be made. Conclusion: In this case, the option for the diagnostic tool was excisional biopsy using an intralaryngeal approach. Histologic results showed a nodular fragment with hyaline replacement and central cavitation, with hematic fibrin clots, suggesting a clot/thrombus.

Background: Encapsulating peritoneal sclerosis is a rare manifestation nowadays. Case report: This was a case report of a young female with ESKD on hemodialysis for more than 6 months with a previous history of continuous ambulatory peritoneal dialysis (CAPD) and recurrent peritonitis which currently presented with painful abdominal distension. The CT scan of the abdomen showed a clumping of small bowel loops at the left side encased into a thin fibrocartilaginous membrane. Initially, she was treated for intrabdominal sepsis however after recurrent admission, IV Methylprednisolone was started followed by high dose steroids and tamoxifen as a treatment for EPS. Surprisingly she improved and had a good clinical response. She had readmitted again after a few months with abdominal pain due to an abrupt stop in steroid but improved again after the steroid was started. Conclusion: Abdominal pain in a patient with history of CAPD peritonitis needs to raise suspicion of EPS even though is rare Radiological Imaging is helpful in making early diagnosis. The most important thing is steroid as a mainstay of the treatment of EPS besides tamoxifen with a minimal one-year duration or lifelong as surgical intervention is very risky.

Background: Sarcoidosis is a multi-system inflammatory disorder characterized by non-caseating granulomas with predominantly lung manifestations that can cause restrictive or, less commonly, obstructive lung disease. Rarely is pneumothorax a manifestation of sarcoidosis; it has been reported as an early finding in sarcoidosis, but it is typically attributed to ruptured bullae, cysts, or pleural granulomas. Case presentation: We present a unique case of spontaneous pneumothorax attributed to biopsy-proven sarcoid disease in a patient with no prior history of pulmonary complications. The patient's rapid development of novel pulmonary sequelae necessitates treatment of sarcoidosis early in disease course. Conclusion: We recommend a treatment plan of appropriate chest tube placement in the affected lung(s) and prompt steroid therapy for patients with sarcoidosis presenting with a pneumothorax. We also review the literature for the etiology, pathophysiology, and presentation of pneumothorax in sarcoidosis, treatment of this sequela, and pulmonary function test findings in these patients.

Background: Psychosis is often solely described as a psychiatric presentation; however, it is vital that organic causes are eliminated, especially in children. Case presentation: We report the case of a 14yr old girl who presented two months history of self-neglect, poor school performance and a week history of mutism. At initial presentation, her neurological examination was normal except for expressive aphasia, and occasional inappropriate laughing. First line investigations showed low vitamin B12 and folate and normal MRI. She was planned for follow up with psychiatrists. She presented about a week later with worsening symptoms. She had further investigations which revealed high homocysteine, in keeping with homocysteine remethylation disorder. She started betaine therapy after which she had a significant improvement in her symptoms. Conclusion: This case emphasizes the importance of thorough investigations of children with acute psychosis before making an assumption of a psychiatric cause, as reversible causes have better outcomes.

Background: Contrast induced encephalopathy is an infrequent complication of contrast media administration. It is usually transient but occasionally leads to permanent neurological deficits and death. Case presentation: We report here a case of non-ionic iodized contrast induced encephalopathy after an urgent coronary angiography, in a 62 year old woman who developed symptoms of acute stroke. Although diagnostic challenge and under not specific but supportive therapy the symptoms resolved completely within 72 hours without further complications. Conclusion: CIE is a rare entity whose frequency is dependent on the increasing use of diagnostic/interventional procedures with contrast media. The exclusion of more common complications of such procedures should be prompt. The clinical scenario is challenging and should be considered, in particular in high-risk patients. The course is generally benign and requires supportive therapy.