1/37. Chronic dacryoadenitis misdiagnosed as eyelid edema and allergic conjunctivitis.PURPOSE: To report the case of a 53-year-old woman with a 2-year history of episodic upper eyelid swelling and nonspecific complaints, who was diagnosed as having allergic conjunctivitis. methods: A complete ocular examination, orbital computerized tomographic (CT) scans followed by complete physical and systemic examinations. RESULTS: The results of physical and systemic examinations were unremarkable for systemic lymphoma and a primary focus of cancer. The results of the ocular examination were normal. CT scans demonstrated well-defined lesions bilaterally with a homogeneous internal structure in the lacrimal gland fossa, which suggested a diagnosis of chronic dacryoadenitis. The differential diagnosis included lymphoma and orbital metastases. The patient refused a biopsy and was started on a tapering dose of 60 mg oral prednisolone daily. The follow-up CT scans 1 month after cessation of 6-week oral corticosteroid treatment showed near complete resolution of the orbital lesions. CONCLUSION: This case demonstrates that orbital inflammation can be misdiagnosed as refractory allergic conjunctivitis.- - - - - - - - - - ranking = 1keywords = gland (Clic here for more details about this article) |
2/37. tetracycline sclerotherapy for the treatment of recurrent pooling of plasma in the submandibular tissue space: case report.We present an unusual case of recurrent swelling after removal of the submandibular and sublingual salivary glands which was found to be the result of a collection of plasma. This was successfully treated by an injection of tetracycline to induce sclerosis.- - - - - - - - - - ranking = 1keywords = gland (Clic here for more details about this article) |
3/37. Excessive concern with physical appearance leading to a diagnosis of adrenal adenoma.We report an unusual case of Cushing's syndrome manifested by anxiety over body image in a 26-year-old nurse. Initial presentation was a 'dermatological non-disease'. Clinical signs became increasingly evident during the course of the disease, justifying an adrenal gland evaluation which showed a secreting adrenocortical adenoma. Surgical treatment led to recovery with return to normal appearance and cessation of her aesthetic complaints. Our observation shows that persistent aesthetic complaints may sometimes reveal early hypercorticism.- - - - - - - - - - ranking = 1keywords = gland (Clic here for more details about this article) |
4/37. Lid swelling and diplopia as presenting features of orbital sarcoid.Sarcoid is an idiopathic multisystem non-caseating granulomatous disease with protean clinical manifestations. In the eye, the common sites of involvement are the skin of eyelid, conjunctiva, uveal tract, retina, optic nerve and lacrimal gland.- - - - - - - - - - ranking = 1keywords = gland (Clic here for more details about this article) |
5/37. Bilateral parotid swelling caused by sarcoidosis.BACKGROUND: sarcoidosis is a multisystem granulomatous disease characteristically causing bilateral hilar lymphadenopathy. Salivary gland swellings also are seen, which mandate recognition by the dental profession. CASE DESCRIPTION: The authors describe a patient whose diagnosis of sarcoidosis was tenuous. Ocular involvement and an elevated serum angiotensin-converting enzyme level suggested a diagnosis of sarcoidosis. Confirmation with a tissue biopsy was achieved only when the clinicians recognized that salivary gland swelling probably represented a manifestation of the disease. Steroid therapy was instituted. CLINICAL IMPLICATIONS: It is important for the dental practitioner to be familiar with the salivary gland manifestation of sarcoidosis. Early recognition and intervention aborts or slows disease progression.- - - - - - - - - - ranking = 3keywords = gland (Clic here for more details about this article) |
6/37. Successful outcome after surgical management in two cases of the "painful variant" of Hashimoto's thyroiditis.OBJECTIVE: To describe two cases of the rare "painful variant" of Hashimoto's thyroiditis (HT) that were refractory to medical management and in which surgical intervention provided the definitive treatment. methods: We thoroughly review the clinical history as well as the laboratory, imaging, and surgical pathology data in these cases, and follow-up of the clinical response over time is provided. The relevant literature is also discussed. RESULTS: A 56-year-old woman, who had remotely undergone a left hemithyroidectomy and had been diagnosed with HT, sought further assessment because of neck pain and edema. Treatment with corticosteroids was partially successful but led to the development of Cushing's syndrome. A 32-year-old man had pain and swelling of the thyroid and was diagnosed with HT shortly thereafter. Levothyroxine treatment was unsuccessful. Both patients underwent thyroidectomy. Chronic lymphocytic thyroiditis (HT) with a variable degree of fibrosis was found on assessment of pathology specimens. The patients remained asymptomatic after the surgical procedure and did not require any further anti-inflammatory therapy. CONCLUSION: In selected cases, surgical treatment may become necessary for effective and permanent control of symptoms and local signs in painful HT. Access to experienced endocrine surgeons is important in order to avoid postoperative complications because the thyroid gland may be small or fibrosed in this rare variant of HT.- - - - - - - - - - ranking = 1keywords = gland (Clic here for more details about this article) |
7/37. Rofecoxib-induced instant aquagenic wrinkling of the palms.An 18-year-old woman presented with a 3-week complaint of exaggerated palmar wrinkling and swelling following brief exposure (1-2 minutes) of her hands to water. She had a history of mixed connective tissue disease and had been started on rofecoxib therapy 1 month prior to the onset of her skin symptoms. Discontinuation of rofecoxib was followed by resolution of symptoms within a period of 3 weeks. Similar palmar skin changes following water exposure have been reported to occur in cystic fibrosis and are thought to be due to increased salt content of the skin and secondary increased water-binding capacity. Rofecoxib is a selective COX-2 inhibitor that has been shown to increase sodium reabsorption in the kidney via effects on prostaglandin E2 and the renal vasculature. The COX-2 protein is also expressed in keratinocytes and plays a role in keratinocyte differentiation. Prostaglandin E2 also plays a role in keratinocyte proliferation and differentiation. Thus rofecoxib may cause increased sodium reabsorption in the skin, as it does in the kidney. The rofecoxib-associated elevation in skin sodium may increase keratin water-binding capacity and cause exaggerated aquagenic wrinkling of the skin, as occurs in cystic fibrosis.- - - - - - - - - - ranking = 2keywords = gland (Clic here for more details about this article) |
8/37. A primary sjogren's syndrome patient with marked swelling of multiple exocrine glands and sclerosing pancreatitis.A 55-year-old man suffered from nasal obstruction, swelling of the salivary glands, and diplopia caused by markedly enlarged lacrimal glands. The diagnosis of primary sjogren's syndrome was made by a positive Schirmer's test and nasal mucosal biopsy with severe lymphocyte infiltration. He was also found to have swelling of the whole pancreas and increased wall thickness in the common bile duct and the gall bladder. His serum was positive for an anticarbonic anhydrase II antibody. Since carbonic anhydrase ii is present in the ductal cells of various exocrine organs, this autoantibody is considered to be related to the pathogenesis of primary sjogren's syndrome with a marked swelling of multiple exocrine organs.- - - - - - - - - - ranking = 6keywords = gland (Clic here for more details about this article) |
9/37. Kimura's disease of parotid gland presenting as solitary parotid swelling.BACKGROUND: Kimura's disease is a chronic inflammatory disorder of unknown etiology commonly seen among orientals and characterized histologically by lymphatic follicles, vascular proliferation, and marked eosinophilic infiltration. It has a predilection for the head and neck region. The lesion is benign but can be mistaken to be a malignant lesion. methods: Between January 1987 and December 1999, eight cases of Kimura's disease were treated at the Department of Plastic Surgery, Hospital Kuala Lumpur. All the patients underwent surgical excision followed by initial high-dose steroid therapy and low-dose maintenance. RESULTS: All the patients are men, seven belong to the Malay race and one is Chinese. The patients' ages at diagnosis are 18 to 46 years. All were initially seen with swelling in the parotid gland, ranging from 1 year to 20 years' duration. pruritus of the overlying skin was seen in seven patients. Treatment by surgical excision and steroid therapy has led to no recurrences. CONCLUSION: Kimura's disease of parotid gland is rare. It is a chronic inflammatory condition also called eosinophilic hyperplastic lymphogranuloma. Treatment by surgical excision and steroid therapy has led to no recurrences.- - - - - - - - - - ranking = 6keywords = gland (Clic here for more details about this article) |
10/37. Ultrasound findings of iodide mumps.Iodide mumps, swelling of salivary glands after contrast medium injection, is a rare adverse reaction. We present a case in a 73-year-old man with advanced gastric cancer. About 10 min after a CT scan performed with intravenous injection of 140 ml of the low osmolality contrast agent Ioxaglate (Hexabrix 320, Guerbet, france), he complained of progressive swelling of the submandibular area. Ultrasound showed diffuse swelling and internal low echoic thick septa in the submandibular glands bilaterally. Approximately 1 h afterwards, the swelling of his submandibular glands started to regress and returned to normal within a day.- - - - - - - - - - ranking = 3keywords = gland (Clic here for more details about this article) |
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