Introduction
Since the introduction of tyrosine kinase inhibitors (TKI) as primary therapy for patients with chronic myeloid leukemia (CML), the prognosis of these patients has improved significantly, and the number of patients who progress to the blast phase has decreased considerably.
Case report
We report the case of a 35-year-old CML patient in accelerated phase treated with nilotinib, who presents a severe COVID-19 infection requiring non-invasive ventilation, and who subsequently presents a multiple cranial nerve palsy revealing a blast crisis of his CML.
Discussion
Multiple cranial nerve palsy is a sign of neurological involvement of CML in its blast phase. The blast crisis represents a real challenge for the clinician, especially during COVID-19 infection. The treatment remains the association of a TKI with a chemotherapy protocol, as well as the administration of methotrexate and cytarabine by intrathecal and intravenous infusion in high doses.
Conclusion
Despite the importance of the association of CML with COVID-19 infection, there is not yet enough data to know the true impact of this infection on the evolution of this hemopathy.
Many complications are known to occur in association with a diaphragmatic hernia. Acute pancreatitis occurring in this situation is very rare. In this paper, we report a case and describe the radiographic features of this complication. We report an unusual case of acute pancreatitis complicating a neglected post-traumatic diaphragmatic hernia in a 30-year-old male. This patient had a history of an abdominal trauma 5 years ago, and arrived at the emergency room with epigastria and left chest pain and vomiting. Serum lipase was elevated. Acute pancreatitis could be considered as an exceptional complication of diaphragmatic hernia. It is a serious diagnostic and therapeutic challenge. The fundamental roles of CT are to determine the diaphragmatic defect, the abdominal content involving, the Balthazar scoring of pancreatitis, and the presence of local complications. Even if a conservative approach is preferred when facing a diagnosis of pancreatitis, timing of surgery should be carefully considered.
The global pandemic caused by the SARS-CoV-2 has resulted in an increased incidence of venous thromboembolism among hospitalized COVID-19-patients, especially those who required intensive care, despite thromboprophylaxis. This has resulted in the use of higher doses of thromboprophylaxis or therapeutic anticoagulation therapy even in the absence of thrombotic events. However, after their hospital discharge, authors and current guidelines are not unanimous about extended anticoagulant therapy in patients with COVID-19. Here, we report two pulmonary embolism cases following hospitalization for COVID-19, despite intermediate doses of thromboprophylaxis. These rare cases suggest that there may be a residual thrombotic risk following hospitalization for COVID-19 and highlight questions about extended prophylactic-anticoagulation therapy after hospital discharge of patients with COVID-19.
L’encéphalopathie de Wernicke est une pathologie carentielle causée par un déficit profond en thiamine (vitamine B1). Elle survient le plus souvent sur un terrain alcoolique, mais parfois elle est de diagnostic difficile et dont l’évolution en l’absence de traitement conduit à des séquelles cognitives sévères. L’imagerie par résonance magnétique est l’examen de référence permettant de confirmer le diagnostic par la présence d’hyper signaux T2 au niveau périaqueducal, des thalami, et des corps mamillaires. Nous rapportons l’observation d’une femme de 30 ans ayant des vomissements abondants lors du premier trimestre de la grossesse (hyperemesis gravidarum), à l’origine d’une encéphalopathie de Wernicke symptomatique.
Choroidal metastasis is the most common malignant intraocular tumor. Its diagnosis in a patient with known lung cancer is usually easy. However, without any context of already known cancer, further elements are needed to guide the diagnosis. We report the case of a 47-year-old patient with a history of smoking who presented a choroidal metastasis of left lower pulmonary lobe adenocarcinoma discovered on imaging. Imaging techniques, mainly ultrasonography, CT scan, and MRI can help guide the diagnosis of choroidal metastasis even in the absence of a known origin initially.
Introduction and importance
Soft tissue chondroma is a rare benign tumor with a predilection for hands and feet. The incidence is only about 1.5% of all benign tumors and this neoplasm is rarely seen in the paediatric population. In this paper we report the case of a 14-year-old boy treated for a soft tissue chondroma located next to the left foot second metatarsal.
Case presentation
A 14-year-old boy presented with a slowly growing plantar swelling of the left foot. The mass was solid, mobile, measuring 4 cm and located in soft tissues opposite of the left foot second metatarsal. Magnetic resonance imaging was performed and revealed a mass measuring 37 ∗ 27 mm with regular seams, on iso-signal T1 and hyposignal T2 without any skeletal connection. A marginal excision of the mass was performed and the postoperative time was uneventful.
Clinical discussion
The clinical presentation of soft tissue chondroma is generally not specific which makes the diagnosis mostly challenging. Magnetic resonance imaging is the most performed paraclinical examination that allows a better analysis of the lesion. A surgical excision of the tumor is the treatment of choice.
Conclusion
Soft tissue as a primary site of chondroma is a rarely reported localisation and this neoplasm should be kept in mind as a possible diagnosis face to any plantar mass in childhood.
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