1/5. Plumbism or lead intoxication mimicking an abdominal tumor.The clinical presentation of lead intoxication may vary widely and in the absence of a high clinical index of suspicion, the diagnosis may be missed. The effects of lead on mitochondrial oxidative phosphorylation and its interaction with calcium-mediated processes explain the heterogenous presentation. In this case report, the diagnosis was finally made when bilateral wrist drop developed on top of abdominal cramps and anemia. Before, ascites raised the suspicion of a tumor. Therefore, each element of the triad of unexplained anemia, abdominal cramps, and bilateral wrist (or foot) drop should lead any physician to consider the diagnosis of lead intoxication. This case also illustrates the importance of a careful and meticulous social history in patient management.- - - - - - - - - - ranking = 1keywords = physician (Clic here for more details about this article) |
2/5. Metastatic tumors of the umbilicus: a review 1830-1989.Umbilical metastases from known and unknown primary cancers are rare. The eponym "sister mary joseph's nodule" has been used by generations of physicians. The first reports of this clinical sign were from Walshe in 1846. A review of the literature revealed 265 cases from then until 1989. Only 85 cases of umbilical metastasis from unknown primary tumors were found. This review should help us to focus on the common and uncommon primary sites in the diagnosis of patients with this finding. A single case report and the work-up for the hidden primary tumor are described.- - - - - - - - - - ranking = 1keywords = physician (Clic here for more details about this article) |
3/5. adenocarcinoma arising in an ileostomy. Report of two cases and review of the literature.adenocarcinoma arising in an ileostomy is rare. Two cases are reported, one of a 58-year-old woman and the other of a 54-year-old man who had each undergone a colectomy for chronic ulcerative colitis. Seven other cases previously reported in the literature are reviewed. Though the exact pathogenesis is uncertain, several possibilities, particularly with regard to antecedent dysplasia and backwash ileitis, are discussed. Routine yearly follow-up and examination of the stoma by a physician or enterostomal therapist may lead to earlier detection of this rare complication.- - - - - - - - - - ranking = 1keywords = physician (Clic here for more details about this article) |
4/5. Uptake of I-131 by an abdominal neurilemoma mimicking metastatic thyroid carcinoma.I-131 whole-body imaging may show characteristic findings in functioning, metastatic differentiated thyroid carcinoma. Nonthyroidal tumor uptake of I-131 is rare, but may mislead the physician to inappropriate treatment. A case is reported of a 59-year-old woman with papillary thyroid carcinoma who demonstrated strong uptake of I-131 in an abdominal cystic neurilemoma. Her serum thyroglobulin concentration at that time was low, at 3.35 ng/ml. Although the concentrating mechanism of I-131 was not clear, several clues pointed to the possibilities of nonthyroidal tumor uptake: 1) faster clearing of radioactivity than usual thyroid tissue, 2) persistent low serum thyroglobulin concentration, and 3) the presence of a cystic component in the nonthyroidal tumor.- - - - - - - - - - ranking = 1keywords = physician (Clic here for more details about this article) |
5/5. Portsite and intraabdominal metastases of unsuspected gallbladder carcinoma after laparoscopic cholecystectomy: report of a case.We herein report a rare case of portsite metastasis of gallbladder carcinoma which occurred after laparoscopic cholecystectomy. A 64-year-old man underwent laparoscopic cholecystectomy at another hospital for symptomatic cholecystolithiasis. The histological examination revealed an adenocarcinoma of the gallbladder infiltrating the entire wall. Despite the physician's advice the patient refused any additional treatment. Thirteen months after surgery he visited our hospital because of a palpable mass at the scar of the right trocar incision. The nodule was removed and histological examination confirmed metastasis from the gallbladder carcinoma.- - - - - - - - - - ranking = 1keywords = physician (Clic here for more details about this article) |