Small bowel obstruction is a common operative finding following an acute surgical admission. However, small bowel obstruction due to an enterolith is a rarer finding. Enteroliths are formed in conditions contributing to hypomotility and stasis within the gastrointestinal tract. These include Crohn's disease, strictures, and intestinal diverticulae. We present a case of small bowel obstruction due to an enterolith in an 89-year-old female. In our case, CT identified an inflamed jejunal diverticulum pre-operatively.
We report the case of a 59-year-old Caucasian male with a primary in ltrative BCC with vascular invasion on the right temple. An excision biopsy was taken and histology con rmed BCC, 2.5mm thick, invading into the reticular dermis. The patient underwent a scar excision which demonstrated no further malignancy. The patient showed no clinical signs of recurrence 2 years a er diagnosis.
Relevance:Basal cell carcinoma (BCC) is the most common human malignancy and its incidence is increasing. Less than 1% of BCCs metastasize and very few cases of intravascular invasion by a primary BCC have been reported. This report discusses the clinical features of a BCC, the population at risk and summarises all known cases of BCC with vascular invasion in the literature.
Take Home Messages:Due to the rarity of basal cell carcinoma with vascular invasion, there is a poor understanding of the disease process and the metastatic potential, resulting in uncertainty for clinician and patient regarding appropriate management.The British Student Doctor, 2020;4(1):41-44
The 2001 Bethesda System (2nd edition) indicates that parakeratosis with nuclear enlargement, hyperchromasia, irregular contours, and/or three dimensionality should prompt consideration of an interpretation of ASC-US or greater. The authors retrospectively reviewed 812 liquid-based cervicovaginal cytology samples (CVCSs) interpreted as ASC-US during an 11-month period. All slides were studied for the presence or absence of atypical parakeratotic spires (APKSs), a specific form of atypical parakeratosis. Results from corresponding Hybrid Capture II high risk (HR) HPV testing were recorded (blinded). Of 812 women, 28% (230/812) had APKSs and 20% (163/812) had positive HCII assays for HR HPV. Three percent of all reflexed ASC-US vials (26/812) had both APKSs and positive HR HPV assays (sensitivity = 16%, specificity = 69%). APKSs in liquid-based CVCSs interpreted as ASC-US do not independently correlate to a positive reflex test for HR HPV (P < 0.0001). This suggests that APKSs are most often unrelated to underlying HR HPV infection. The finding of APKSs alone in CVCSs does not warrant an interpretation of SIL and should be used only in concert with other findings to label a sample as ASC-US.
Leiomyomas are a common gynaecological finding affecting 20-30% of women over the age of 35, with prevalence decreasing following menopause. Around 25% of women present clinically with a leiomyoma, which are most commonly found within the uterus. Rarer extra-uterine locations include the broad ligament, cervix, and vagina. We present a rare case of an extra-uterine leiomyoma located in the perineum of a 59year-old female. Our case highlights the importance for extra-uterine leiomyoma to be considered as a differential diagnosis in patients presenting with a pelvic mass following hysterectomy.
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