Journal of Clinical Case Reports

A 55-year old male was admitted to our hospital with neck pain along with numbness and tingling sensation in his left arm. On detailed evaluation, he was diagnosed to have Pancoast tumor. This case report presents the clinical presentation of Pancoast tumor and emphasizes the importance of its inclusion in the differential diagnosis of patients presenting with persistent neck pain.

Background: Gastric cancer is a leading cause of death worldwide and the average survival rate of patients within a year of diagnosis remains low. Currently, surgical resection is the major treatment strategy, and the effectiveness of chemotherapy remains debatable. Infections involving Helicobacter pylori (H. pylori) and the Epstein-Barr virus have been implicated in gastric cancer pathogenesis. In addition, extensive immunosuppression in patients caused by latent infections and chemotherapy limits their response to existing therapies. Case presentation: A 73-year-old man presented with stage IV gastric cancer (T2N0MII stage, cell group II). The tumor was inoperable due to concomitant multiorgan dysfunction and consequently, the patient was treated with a combinatorial therapy consisting of immunocorrective and antimicrobial therapy, as well as chemotherapy. The medications used for treatment include interferon-α, interleukin-2, statins, fenofibrate, macrolides, proton pumps, and antiviral drugs. Following treatment, tumor cells redifferentiated into normal glandular epithelial cells. A 2-year followup study of the patient after treatment revealed a complete remission from cancer. Conclusion: This case report demonstrates the possibility of using a systemic approach to treat inoperable gastric cancer. In addition, the observations made in this study should aid the design of novel treatment strategies for gastric cancer.

We describe the case of a young female on chemotherapy due to lymphoid leukemia, which developed late persistent candidemia with multiple intra-abdominal microabscesses consistent with chronic disseminated candidiasis, formerly called hepatosplenic candidiasis.

After peripartum asphyxia, metabolic acidosis and neurological derangement are clinical findings. In severe cases, treatment with hypothermia should be started within six hours after birth. A rare cause of neonatal metabolic acidosis is maternal metabolic derangement due to Diabetic Keto Acidosis (DKA). We report characteristics of a boy born at 336/7 weeks gestation to a mother with unrecognized DKA in gestational diabetes mellitus. Persistent metabolic acidosis and severe neurological derangement resulted. Diagnosed as severe peripartum asphyxia, hypothermia was started. Hours after delivery, the mother was diagnosed with DKA. Although the child’s diagnosis of peripartum asphyxia was revised, hypothermia was continued. In newborns with severe metabolic acidosis and normal serum lactate, maternal metabolic derangement due to DKA should be considered. In those cases hypothermia is not proven effective. Early recognition and treatment of maternal DKA potentially prevents fetal death, neonatal sequelae and in less severe cases, unnecessary invasive hypothermic therapy.

Lipoma is one of the commonest benign mesenchymal tumors in body and found almost in all organs where the fat exists. It is usually small but giant lipomas can be present in thigh, shoulder and trunk. The present study describes a 46 year old male with a huge mass right loin which on histopathology revealed features suggestive of lipoma.

Panhypopituitarism can manifest itself with variable signs and symptoms, and in some cases it may be responsible for serious events such as cardio-respiratory insufficiency and hypoglycemia which can be fatal. It can be assumed that a condition of panhypopituitarism can cause early sudden death that occurs in the first hours of life. For this reason it is important that the post mortem examination in SIDS (Sudden Infant Death Syndrome) patients includes the study of the pituitary gland. We present a newborn with panhypopituitarism, in which the onset was dramatic, with severe cardio-respiratory insufficiency and severe hypoglycemia and only the accidentally detection by midwives was life saving. Array CGH analysis showed a microdeletion of chromosome 5q34, including part of the intronic region of the gene ODZ2 inherited from the mother, not related to the patient’s symptoms so far.

Pregnancy in uterine didelphys is a relatively rare condition and the mode of delivery in these patients is unclear. Uterine didelphys is not an indication for caesarean section. We report a case of uterus didelphys who had a vaginal delivery.

Cerebral palsy is defined as motor impairment that limits activity, and is caused by non-progressive disruption during cerebral development in fetus or infant. The standard treatment is focused on rehabilitation and symptomatic management, which does not address the underlying brain damage. Recently cellular therapy has been seen as promising strategy to improve function of damaged areas of brain. Many mechanisms of action are postulated including cytokine release, angiogenesis, activation of satellite cells, decrease inflammation decrease neuronal apoptosis; and neuronal regeneration. We present a case of a two year old girl with spastic cerebral palsy, who was administered autologous bone marrow derived mononuclear cells intrathecally. Six months after the therapy she showed significant functional improvements along with correlating dramatic changes in Positron Emission Tomography-Computed Tomography scan. These changes provide objective evidence of functional restoration of affected areas of brain by cellular therapy.

An 8 month old child was referred to us from department of paediatrics as a case of non-resolving pneumonia of 2 months duration. Bronchoscopy of the patient revealed obstruction as the cause, with a paddy grain in the right main bronchus. The grain was removed and was found in germinating phase confirming its presence for a long duration. The child improved clinically soon after the procedure.

Intussusception is a well-recognized clinical entity that has been mainly attributed to pediatric population. Adult intussusception is an extremely rare condition presenting with diverse symptomatology. A high index of suspicion and early diagnosis with a CT scan will identify patients requiring emergent surgery. Present case report describes a patient with presentation of acute appendicitis and ultimately diagnosed to have ileocolic intussusception. Laparoscopic reduction of the intussusceptions and appendectomy cured the condition.