Журнал клинических случаев

The study aims to compare the clinical outcome of External Fixation (EF) and Plating Fixation (PF) in the treatment of displaced midshaft clavicle fractures in adults. Fifty-nine patients meeting the inclusion criteria were selected; 29 cases of external fixation and 30 cases of open-reduction plate fixation. The average follow-up period was 32 months. Outcomes analysis included: satisfaction with the received treatment, local appearance and shoulder function; residual symptoms; Constant Shoulder Score (CSS); Disability of the Arm, Shoulder and Hand Score (DASH). 25 cases of EF and all patients in PF group were successfully followed up. No statistically significant differences were observed between two groups in overall satisfaction (P=0.12), CSS (P=0.132), DASH (P=0.113), or healing time (P=0.086). In the EF group, there was one case of nonunion (4%) and three cases of angular deformity. PF group had one case of nonunion (3%) and no malunion; hardware irritation and the need for a second surgery were the biggest complications. Compared with PF, EF provided a better treatment overall, with the advantages of simple procedure, no damage to the soft tissue and blood supply, a short healing time, and no second operation.

Panayiotopoulos Syndrome (PS) is a benign, common, age-dependent syndrome, with susceptibility to idiopathic vegetative seizures and autonomic status epilepticus. It is formally recognized by the International League against Epilepsy (ILAE). It is one of the three focal epileptic child benign syndromes next to rolandic epilepsy and idiopathic occipital epilepsy in children. It is characterized by its relative mildness and confusing manifestations. It is frequently misdiagnosed as non-epileptic disorders.

Hemangioma is a common disease of vascular surgery. It is the great benefit for the detection of blood flow status through the vessel imaging methods, which is the basis and key of diagnosis for hemangioma. However, it is difficult to diagnose for those hemangiomas in the deeper tissues, the changes do not show the specific imaging. Among the patients with hemangioma, we retrospectively analyzed a patient whose mass occurred in the muscle tissues of leg. The imaging of B-mode ultrasound diagnosed as hemangioma and the pathological diagnosis is administrated as the lymphoma after surgery.

Introduction: Anaplastic Large Cell Lymphoma (ALCL) is a rare distinct subset of T-cell non-Hodgkin lymphomas (T-cell NHL). Anaplastic Lymphoma Kinase (ALK) positive ALCL patients are generally associated with younger age and have a better prognosis. While Central Nervous System (CNS) involvement in T-cell NHL is rare and has a dismal prognosis. There was no report about ALK + ALCL and CNS vasculitis.

Case presentation: A 17-year-old boy who was diagnosed ALK + ALCL and underwent six courses of systemic chemotherapy presented as severe CNS vasculitis in the beginning, but eventually he was diagnosed CNS metastasis of ALCL by the presence of cranial nerve palsy, the demonstration of lesions on MRI and PET-CT, and Flow cytometry detection of tumor cells in Cerebrospinal Fluid (CSF).

Conclusion: We first present a case of CNS metastasis of systemic ALK + ALCL accompanied with CNS vasculitis. When an ALK + ALCL patient had CNS symptoms while imaging revealed CNS vasculitis, we need to be vigilant that the patient may have CNS involvement.

Granular Cell Tumors (GCT) is very uncommon tumors and was first described by Abrikossoff in 1926. They are small, painless, slow-growing subcutaneous nodules most commonly seen in the tongue and oral mucosa. 5-16% of the granular cell tumors have been reported in the vulva. To our knowledge, the imaging findings of GCT of the vulva were not described in the literature before. In this case, we present the imaging findings of a 63-years-old female who had GCT of the vulva. On ultrasonography there was ill-defined, lobulated heterogeneous solid mass with central hypoechoic and peripheral slightly hyperechoic areas in vulvar subcutaneous fat. On MRI, the tumor was hypointense on T1 and T2-weighted images compared to fat tissue, isointense with muscles on T1-weighted images and on T2-weighted images slightly iso-hyperintense with muscles. Dynamic examination showed early diffuse enhancement more peripherally, which were also continuing on late phase images. On CT, the tumor was isodense to adjacent muscles and showed minimal enhancement. There were no regional or distant metastasis and no lymphadenopathy. The tumor was treated by wide surgical excision and pathology was consistent with granular cell tumor.

Arrhythmogenic right ventricular dysplasia/cardiomyopathy is an inherited cardiac disorder that predisposes to sudden cardiac death, particularly in young patients and athletes. Physical exercise promotes the phenotypic expression of the disease and accelerates the onset of life-threatening ventricular arrhythmias. We report the case of a 42-year-old male who was diagnosed with arrhythmogenic right ventricular dysplasia after his first episode of ventricular tachycardia that occurred during a football match.

Adverse events to vaccine or vaccine induced reactions and particularly hypersensitivity post-vaccination reactions to the rabies vaccine, are very rare. Therefore, we wanted to show a case of a four-year-old girl who developed an allergic reaction after a dog and cat bite during rabies postexposure prophylaxis. Sensitization to some component of the infectious agent of the rabies vaccine, grown on purified chick embryo cells but also on human diploid cells, has been proven. Although, allergic reactions to the rabies vaccine are extremely rare, vaccination can be done following the official WHO guide for pre-exposure and post/exposure prophylaxis in humans.