Журнал клинических случаев

Mucinous adenocarcinoma(MC) of prostate is extremely rare, with an incidence of approximately 0.2% Mucinous adenocarcinoma of the prostate usually has no obvious symptoms, its usual clinical symptom are frequency, dysuria, difficulty in voding which are similar to benign prostate hypertension, the diagnosis of mucinous adenocarcinoma is made only when extraluminal pools of mucin involve at least 25% of the tumor volume at prostatectomy, the different with the prostate acinar cell carcinoma is that MC is more likely to occur in skeletal and visceral metastases. Some studies suggest that 77.8% of MC patients’ PSA will be increased, and there is no significant difference in the degree of increase compare with the prostate acinar cell carcinoma. This case report describes the excellent clinical course of a 74-year-old patient with mucinous adenocarcinoma of the prostate, treated by trans-urethral resection of prostate (TURP). In our case, mucinous adenocarcinoma of the prostate does not appear to behave differently than acinar prostate cancer, and with a review of the current literature.

Resin bonded fixed partial denture (RBFPD) has been used clinically since the 1970s, and offers a more conservative approach than conventional fixed prosthesis for restoring edentulous short span. RBFPD is inexpensive to fabricate, easy to insert, and has been shown to be cost effective for the patients. In the present article, this type of restoration has been tried to restore mandibular anterior edentulous span. Other treatment options have been ruled out, because of the patient’s medical condition, or the patient’s preference. The patient has been followed-up for more than two-year without any complication.

We present a 56-year-old male kidney transplant recipient who was hospitalized for acute kidney injury due to gastroenteritis related volume depletion and had kindey function deterioration secondary to rising plasma levels of tacrolimus after metronidazole administration. Tacrolimus dose was decreased and arranged daily by closely drug level monitoring. His creatinine value returned to his basal levels after metronidazole was stopped and his tacrolimus levels were kept in target range. Tacrolimus is metabolized primarily in the liver by CYP3A enzymes and drugs that affect CYP3A functions such as metronidazole can cause elevated tacrolimus plasma levels that results in nephrotoxicity. This case teach us that calcineurin inhibitors should be closely monitored in kidney transplant recipients during metronidazole treatment.

Surgical treatment for neurogenic bladder has evolved notably. A great number of patients with neurogenic bladder also present fecal incontinence and treatment for these patients is discouraging. With the induction and use of the Malone procedure through appendicostomy, the practitioner may offer the confection of a stoma for coecal catheterization, allowing easy access for daily enemas. The objective of this report is to present one surgical technique, where the coecal appendix was divided on the proximal portion created a stoma for antegrade enema (Malone principle) and the distal portion created a stoma for urinary catheterization in an augmented bladder with an intestinal segment (Mitroffanoff principle).

Based on remarkable and sustained antitumor activity, the anti-CTLA-4 antibody ipilimumab, and anti-PD1 antibodies nivolumab and pembrolizumab have been approved for treatment of advanced melanoma. As checkpoint blockade is associated with potentially serious immune-related adverse events, including autoimmune hepatitis, clinical trials evaluating these agents have excluded patients with chronic hepatitis B virus infection. Herein, we describe one patient with advanced melanoma and concomitant HBV infections experiencing seroconversion of HBsAg after treatment with combination of PD-1 and CTLA-4 blockade.

Volvulus is a rare cause of intestinal obstruction. The main types of colonic volvulus are sigmoid volvulus and cecal volvulus. The simultaneous occurrence of cecal and sigmoid colon volvulus is extremely unusual. To our knowledge, few reports on simultaneous sigmoid and cecum colon have been published to date. We are reporting a case of a synchronous volvulus of ceacum and sigmoid colon.

Schwannoma is a benign tumor arising from peripheral nerve sheath cells. It is rare to find them outside head, neck and extremities. We report a rare case of an incidentally detected large retroperitoneal mass in a 62-yearold male by radiological investigation, who underwent fine needle aspiration cytology which was insignificant and proceed for excision, which was found to be schwannoma on histopathological examination.

Granulomatosis with polyangiitis and Crohn’s disease are two distinct chronic inflammatory diseases that may involve various organ systems, including the alimentary tract and the oropharynx. In both diseases there is an association with different types of anti-neutrophil cytoplasmic antibodies. We describe a patient previously diagnosed with Crohn’s disease, presenting 20 years later with a rapidly progressive glomerulonephritis and histological evidence of crescentic glomerulonephritis and surrounded by severe interstitial inflammatory infiltrate, ultimately diagnosed as having granulomatosis with polyangiitis.

Chest injury penetrating to the heart occurs relatively rarely. The additional presence of a foreign body in the right ventricle is even more uncommon. Thus, we aim to present the case report of a wire located in the heart of a 29-year-old woman. A decision to perform a surgery was based on patient’s examination, chest X-ray, and computed tomography (CT). The patient was discharged from the hospital seven days after the surgery, symptom-free.

Peritoneal dialysis has been a reliable alternative treatment for end-stage renal disease. However, it is not exempt of complications. In this manuscript, we describe an uncommon case of pericatheter herniation, complicated with small bowel obstruction, which required an emergent surgical procedure. CT scan was needed to reach an accurate diagnosis. Pericatheter hernia is a complication that must be suspected in patients undergoing peritoneal dialysis who show signs of small bowel obstruction.