Case Reports in Clinical Practice
Volume:4 Issue: 4, Autumn 2019

Oncocytic cysts of the larynx are benign and rare lesions constituting a pathologically distinct sub-group of cysts. In this report, we present a case with dyspnea with two large masses on false vocal cord identified by video laryngoscopy. Fiberoptic nasotracheal intubation revealed oncocytic laryngeal cysts.

In this case study, we presented the radiological characteristics of a 43-year-old female patient diagnosed with Multiple Sclerosis (MS). Following mitoxantrone administration, she developed liver failure. Magnetic Resonance Imaging (MRI) revealed multiple periventricular lesions in T2 and bilateral involvement of putamen and Globus Pallidus (GP) areas in T1 sequences.

This research aimed to assess the effect of a specific herbal agent to gain weight as the potential cause of Portal Vein Thrombosis (PVT) and hepatic damage. In this study, we reported a 24-year-old man who referred to the Tehran University of Medical Sciences (TUMS) hospital complaining of 4-day progressive abdominal pain. The patient’s abdominal pain was generalized with a mild tenderness over the epigastric region. He complained of nausea, vomiting, and loss of appetite. However, he reported no hematemesis, melena, or dyspnea, with unremarkable past and family medical history. An abdominopelvic ultrasound and Computed Tomography (CT) scan were conducted for further investigation of the patient, which revealed extended filling defect in portal vein and its branches. In addition, the evidence of liver hypoperfusion was found because of geographic hypodense lesion seen in the major parts of the right lobe and the IV segment of the left lobe. The patient was further assessed for any acquired or inherited potential prothrombotic state associated with abdominal vein thrombosis, which were all rolled out. However, his round moon face, purplish striae, and the back acne increased the suspicion of drug side effects. Finally, a herbal agent (Fereshteh tablet) was found as the cause of the patient’ disease. He consumed the tablet to gain weight from 3 months ago. His thrombosis was treated with subcutaneous enoxaparin, as well as oral intake of warfarin. He was recommended to check liver function regularly at outpatient hepatobiliary clinic after discharge.

Skin involvement is not common as the first manifestation of Multiple Myeloma (MM).
Although extremely rare, leucocytoclastic vasculitis, plasmasytoma, autoimmune bullous
disease, livedo reticularis and Raynaud’s phenomenon may be the initial presentation
of MM. Raynaud’s phenomenon and livedo reticularis related to cold exposure can be due to Cold Agglutinin Disease (CAD) or cryoglobulinemia and can be seen as the first manifestation of MM. In this case study, we described a 55-year-old man complaining of limbs livedo reticularis and Raynaud’s phenomenon during cold weather. Further evaluations revealed anemia and elevated ESR. Skull X-ray showed multiple punched-out lesions. Finally, serum protein electrophoresis and bone marrow aspiration confirmed the diagnosis of non-secretory MM as the underlying disease of CAD. The patient was referred to the hematologist for the treatment of MM.

Hydatid cyst is a zoonotic disease due to the infection with the larvae of Echinococcus granulosus. The liver and lungs (80%) are the main organs involved and rarely head and neck.

A 47-year-old Iranian man presented to our center complaining of sublingual inflammation for 8 months. Sonography revealed a cystic lesion of 4×5×6 cm within the tongue. CT-scan showed a well-defined and hypodense mass in the floor of the mouth. Cyst resection was performed with the probability of ranula. Pathology was suggestive of hydatid cyst. Further workups revealed liver involvement. Therefore, he was treated with albendazole for 2 months.

The hydatid cyst in the head and neck is rare and the involvement of sublingual gland is extremely rare. However, in endemic areas, hydatid cyst should be considered in the differential diagnosis of head and neck masses.

Lung can be affected by various tumors, including lung carcinoma. These tumors exhibit certain clinical signs. In rare cases, they may appear unusual and affect the diagnostic and therapeutic course. Considering the importance of this issue, in the present study, we report a case of lung lymphoma with subsequent lump masses. We report a diagnostic evaluation in a male case with the first manifestation as an unusual presentation of scalp metastasis due to underlying lung cancer.

Although lung cancer is typically presented in classical form, it is important to consider unusual manifestations of underlying lung cancer, along with the appearance of scalp lesions.

Sepsis is a life-threatening condition that arises when the body's response to infection damages its own tissues and organs. Sepsis is caused by an inflammatory immune response triggered by an infection. Its risk factors include aging, weak immune system, major trauma, or burns. Treatment of sepsis is often based on fluid replacement and antibiotic therapy. In this study, an 83-year-old man is reported with two times of diagnosis of sepsis during three years. The first sepsis was due to an infection of the colostomy and the second one followed an infection at tracheostomy site. It seems that the disease and the underlying condition of the patient contribute to the occurrence of sepsis. The patient each time was discharged from the hospital after successful response to the treatment.

Gaucher Disease is an autosomal recessive lysosomal storage disease. Pulmonary involvement in Gaucher Disease is rare and often seen in the severe form of the disease with the worst outcome.

A 30-year-old man and known case of Gaucher Disease presented to our clinic with history of progressive dyspnea since 8 months ago. Pulmonary function test showed restrictive pattern. Chest CT scan revealed diffuse bilateral interlobular septal thickening and small interstitial nodules with ground glass opacities in lower lobes.

Patients with Gaucher Disease that present with progressive dyspnea may have a manifestation of interstitial or alveolar lung disease.