Schwannomas are tumors of the Schwann cells found in the myelin sheath. They cause 5% of all benign softtissue cancers, occur equally in males and females, and occur later in life. Since they remain asymptomatic, diagnosing and treating them becomes challenging; current guidelines recommend imaging followed by excision. Here, we present a case of a 19-year-old male who presents in an outpatient setting with a history of painless swelling of the fifth digit for the past four years. Past medical history and physicals are unremarkable. Microscopic findings from fine-needle aspiration cytology (FNAC) confirmed the schwannoma diagnosis, showing loosely arranged spindle cells with elongated nuclei with pointed ends dispersed within the myxoid stroma.
Allergic bronchopulmonary aspergillosis (ABPA) is a fungal hypersensitivity reaction in chronic lung diseases like bronchial asthma and cystic fibrosis. It is caused by an allergic reaction to aspergillus antigen in the lung mucus resulting in airway inflammation and damage. This condition usually presents in a patient with asthma as a poorly controlled disease with recurrent infection symptoms that do not respond to standard antibiotic therapy. Diagnosis is made by chest X-ray, computed tomography, eosinophilia, and raised serum IgE on serology and immunological tests for aspergillus antigen. Lack of diagnosis and treatment of the condition can lead to respiratory failure from bronchiectasis and pulmonary fibrosis.
Schwannoma is a rare benign soft tissue tumor that appears like a neuroma based on its specific location and clinical features. We report a case of a plexiform schwannoma in a middle-aged woman who had a painful bump located in the third webspace on the dorsum of her right foot for the last four years. Initially, the swelling was thought to be Morton's neuroma based on location and clinical feature findings. The mass was resected and was sent for histopathological examination, revealing a plexiform schwannoma, most likely developing from the cutaneous nerves on the dorsum of the foot. She reported improvement in her symptoms after complete and careful excision without any neurological deficit. Investigation of any subcutaneous foot swelling should be coupled with a histopathological examination for comprehensive management.
Thromboangiitis obliterans (TAO) also known as Buerger’s disease is a nonatherosclerotic vasculitis that is more common in adult male smokers. TAO predominantly affects lower extremities, however, cases with bilateral upper extremities involvement are a rare entity and difficult to manage. Symptoms of the disease mostly mimic that of acute ischemia of the limb. Diagnosis is mostly made clinically, however, radiographic vascular evaluation can strengthen the diagnosis. Herein we present a case of a 41-years-old male with a history of chronic smoking whose signs and symptoms were suggestive of TAO in bilateral upper extremities, however, the patient did not respond to smoking cessation and pharmacotherapy for a long time owing to which he underwent amputation after taking proper informed consent.
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