We present a case which describes a 29-year-old woman with systemic lupus erythematosus who was treated aggressively with cytotoxic immunosuppression. Five years later and approximately 12 weeks pregnant, she is confirmed as having carcinoma of the tongue. Not wishing to consider termination of her pregnancy, she underwent surgical resection, which included partial glossectomy with microvascular reconstruction. Good oral function (speech and swallowing) was restored within 2 weeks. The pregnancy proceeded relatively uneventfully to 37 weeks gestation when proteinuric hypertension necessitated induction of labour. She remains well with no evidence of recurrence. This case highlights the options available in the treatment of carcinoma of the tongue during pregnancy together with the ethical considerations required, balanced against optimising maternal outcomes.
Infectious tenosynovitis is a rare condition usually presenting with symptoms of joint pain, swelling and deformity. A large number of infectious organisms are known to cause tenosynovitis and prompt and accurate diagnosis is essential to ensure appropriate treatment is delivered before serious complications and functional impairment occurs. We report a case ofMycobacterium bovistenosynovitis, a rare cause of infectious tenosynovitis; we discuss the clinical features and management of this condition and highlight the difficulties encountered in reaching the correct diagnosis and the importance of the appropriate use of biopsy to aid diagnosis.
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