臨床症例報告ジャーナル

A 18yr old female was admitted history of sudden onset mild grade fever with three to four episodes of loose stools four day back which remain for one day and relived with conservative treatment. But from next day she started left temporal throbbing type headache and her mother was noticed that she had difficulty in naming, simple calculation and forgetfulness for recent things.

Fibrous dysplasia is a congenital, no hereditary skeletal disorder where a portion of a bone develops abnormally. It accounts for approximately 7% of all benign bone tumors. It is a developmental anomaly of bone formation in which the marrow is replaced by fibrous tissue. The bones most frequently involved are the long bones: femur (most common), skull, and the ribs.

In children plane film radiographies are still most cost-effective method in evaluating skull fractures but sometimes its difficult to differentiate sutures or vascular groves from fractures. Accesory sutures, such as the mendosal suture, may be misinterpreted as a skull fracture if additional views are not obtained.

Perivascular epithelioid cell tumors (PEComas) are made up of cells with distinctive morphologic, immunohistochemical, ultrastructural and genetic features. They may arise in various locations and are usually benign. Malignant PEComas are rare and associated with an aggressive clinical course and metastatic spread. We present a case of a 56 years old healthy patient who presented with right flank pain and a large mass located at the medial aspect of the right kidney. The mass ruptured during laparoscopic removal. The tumor was eventually labeled as an epitheloid malignant neoplasm most suggestive of malignant PEComa. The patient demonstrated during follow up both local and systemic metastasis that are unresponsive to this point to mTOR inhibition with various agents.

Ewing’s Sarcoma represents 6% of all malignant bone tumours, with an annual incidence of 1/1000000 people. It is a characteristic since the childhood until the 3rd decade of life, to affect primarily the long bones, pelvis, and possibly the soft tissues. Recognizing this fact, it´s essential to value certain recurrent and in specific symptoms.

Purpose: To report a case of conjunctival melanoma (CM) treated with excision and adjuvant mitomycin C. Methods: This is a case report of a 51-year-old female with conjunctival melanotic lesion (10.5 × 5 mm), that was treated with complete surgical excision, combined with perioperative and intraoperative use of mitomycin C 0.02%. Lymphoscintigraphy with 0.3 mCi of technetium Tc-99m sulfur colloid and sentinel lymph node biopsy were also performed. Results: Histological and immunohistochemical staining of the excised melanotic lesion [S-100 (+), Melan (+), Tyrosinase (+), HMB 45 (+)] confirmed the clinical diagnosis of Conjunctival Melanoma. Moreover, lymphoscintigraphy and sentinel lymph node biopsy were negative for tumor metastasis. Ten years postoperatively, there were neither signs of tumor recurrence or metastasis nor late postoperative complications due to mitomycin C. Conclusions: Complete surgical excision combined with perioperative and intraoperative MMC 0.02% was safe and effective in preventing local recurrence in a case of conjunctival melanoma.

Herpes simplex virus (HSV) encephalitis is the fulminant necrotizing viral encephalitis associated with high mortality and morbidity. Here we report a case presenting HSV encephalitis mimicking cerebral infarction without any neurological deficit and subsequently recovered with intensive intravenous acyclovir therapy.

Sinuses of the lower lip are one of the most uncommon congenital anomalies. They usually seen associated with other congenital anomalies of lip and palate .Very rarely a sinus can be seen in the lip associated with trauma.