Ewing sarcoma is a malignant tumor that more commonly affects the long bones. Primary Ewing sarcoma of the adrenal gland is a rare diagnosis. We report an unusual case of primary Ewing sarcoma of the adrenal gland in a 34-year-old man who initially presented with abdominal as well as flank pain and abdominal mass. Computed tomography and magnetic resonance imaging showed a heterogeneous, hemorrhagic right adrenal mass with inferior vena cava extension and thrombosis. Thus, a major open surgery including right adrenalectomy, right nephrectomy, inferior vena cava thrombectomy with resection, and a retroperitoneal lymph node dissection was necessitated. Early recognition with radiological imaging and treatment of extraosseous Ewing sarcoma of the adrenal gland with a multimodality approach reduces morbidity and mortality.
Acute diverticulitis is a painful condition of the gastrointestinal tract that results from sudden inflammation of one or more diverticula in the bowel wall. Right-sided acute diverticulitis, such as cecal diverticulitis, is uncommon diagnosis that can be easily misdiagnosed as acute appendicitis as it shares similar clinical presentation. An unusual complication of right-sided acute diverticulitis such as perforated cecal diverticulitis has different management from acute appendicitis. Thus, definitive diagnosis of this clinical condition with imaging is crucial to optimal management. We report a case of 43-year-old man who presented to the Emergency Department with acute onset severe right lower quadrant abdominal pain associated with anorexia, fever, and nausea. Computed tomography scans obtained showed findings consistent with perforated diverticulitis limited to the cecum, and normal caliber appendix. Conservative medical treatment was decided based on localized imaging findings with excellent outcome.
Ewing sarcoma of the cervical spine is a rare diagnosis. Early recognition and treatment of this condition improves survival. Reported is a case of a 20-year-old male patient who presented with increasing neck pain. Computed tomography and magnetic resonance imaging showed a mass with a primary differential diagnosis of Ewing sarcoma. As a result of mass effect and spinal cord compression, immediate medical intervention was deemed necessary to prevent neurologic deficits.
Well-differentiated thyroid carcinoma is predominantly a slow-growing malignancy, amendable to treatment, and has an excellent prognosis following thyroidectomy and radioiodine (RAI) therapy. However, patients who fail the initial RAI treatment attempt may require repeated RAI or other treatments and with this, comes an associated impact on patient quality of life. Therefore, the anticipation of patients in whom there is a higher risk of RAI failure may help in patient risk stratification and subsequent management. We conducted a retrospective review to determine the factors associated with initial RAI therapy failure in well-differentiated thyroid cancer patients. Using scikit-learn from Python, we implemented a machine-learning algorithm to determine the clinical patient factors associated with a higher likelihood of treatment resistance. We found that clinical factors such as tumor focality ( P = 0.026) and lymph node invasion at surgical resection ( P = 0.0135) were significantly associated with initial treatment failure following RAI. Elevated serum thyroglobulin (Tg) and Tg antibody levels following surgery but before RAI were also associated with treatment resistance ( P < 0.0001 and P = 0.011 respectively). Less expected factors such as decreased time from surgery to RAI were also associated with treatment failure, however not to a statistically significant degree ( P > 0.064). Clinical outcomes following RAI can be stratified by identifying factors that are associated with initial treatment failure. These findings can help restratify patients for RAI treatment and change patient management in certain cases. Such stratification will ultimately help to optimize successful treatment outcomes and improve patient quality of life.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.
hi@scite.ai
10624 S. Eastern Ave., Ste. A-614
Henderson, NV 89052, USA
Copyright © 2024 scite LLC. All rights reserved.
Made with 💙 for researchers
Part of the Research Solutions Family.