IntroductionLimb subcutaneous emphysema secondary to a Munchausen syndrome represents a rare and severe entity because it involves the functional prognosis of the limb and vital prognosis of the patient.Case presentationWe report the case of an 18-year-old Moroccan woman patient who presented to our hospital with a subcutaneous emphysema of the shoulder girdle and the right arm, caused by our patient. Treatment was aggressive, with a wide surgical debridement, parenteral antibiotic therapy and hyperbaric oxygen therapy. The results have been favorable.ConclusionsThe correlation of anamnestic data and clinical and para-clinical exams were essential for the diagnosis of Munchausen syndrome in this case. In this regard, we report a rare case of subcutaneous limb emphysema secondary to Munchausen syndrome.
Abstract:Myxofibrosarcoma or myxoid variant of malignant fibrous histiocytoma (MFH) is one of the most common sarcomas in the extremities in adults and particularly in elderly patients. It is characterized by a high frequency of local recurrence. We report a patient with high grade myxofibrosarcoma infiltrating the striated muscle of the right forearm. On microscopic examination, the tumor lacked areas of necrosis and pronounced cellular pleomorphism. Immunohistochemically, the tumor cells showed intense reactivity to S-100 protein (PS 100) and discrete reactivity of desmin, CD34 and SMA. After surgery of the tumor, the patient received local radiotherapy and chemotherapy. One year after treatment, the patient has been alive without local recurrence or distant metastasis.
The authors describe a case of necrotizing fasciitis of the upper extremity resulting from human bite managed successfully, and emphasize the importance of early diagnostic prompt treatmentand prevention.
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