1/10. October 1998--61 year old male with brain tumor and oral, lung, and palpebral masses.In Jan. 97 a gliosarcoma was diagnosed in a 61-year- old man after a 6-month history with neurological deficits. A total physical examination, laboratory tests, chest x-ray and abdominal ultrasound scanning revealed no gross abnormalities. Surgery was followed by brain radiation therapy and 6 months later there were metastases to the oral cavity, right palpebra and both lungs. The histological findings of the oral and palpebral metastases revealed only the sarcomatous component. We are aware of 15 cases of gliosarcoma with extraneural metastases, and in 4 of these, the metastases contained only the sarcomatous component. We believe that our case represents the fifth case of pure sarcomatous metastases.- - - - - - - - - - ranking = 1keywords = physical examination, physical (Clic here for more details about this article) |
2/10. Blue rubber bleb nevus syndrome in a patient with ataxia and dementia.Blue rubber bleb nevus syndrome (BRBNS), an uncommon disorder characterized by cavernous hemangiomas, most often of the skin and gastrointestinal tract, is usually diagnosed during childhood and young adulthood. We made this diagnosis in an octogenarian referred to a geriatric medicine clinic because of concerns about his ability to live independently. ataxia, dementia, focal neurologic signs, and bluish/purplish vascular nodules on his lips, buccal mucosa, tongue, chest, and neck were noted on physical examination. magnetic resonance imaging (MRI) revealed an old left parietal infarction, multiple cavernous hemangiomas most densely concentrated in the subcortical structures and cerebellum, and areas of hemosiderin deposition. skin biopsy findings were consistent with hemangioma. The physical examination, MRI, and skin biopsy made a diagnosis of BRBNS likely. The patient's ataxia, dementia, and other neurologic signs can be explained by previous hemorrhage from the vascular malformations in his brain. Blue rubber bleb nevus syndrome is an uncommon cause of a relatively common geriatric syndrome presentation.- - - - - - - - - - ranking = 2keywords = physical examination, physical (Clic here for more details about this article) |
3/10. Malignant fibrous histiocytoma of the head and neck after radiation for squamous cell carcinoma.A 60-year-old man presented with malignant fibrous histiocytoma of the oropharynx. The mass extended into the nasopharynx and larynx and caused severe upper airway obstruction that required emergency tracheotomy. Ten years earlier, he had undergone a right partial glossectomy and segmental mandibulectomy for squamous cell carcinoma of the right tongue base,followed by 50 Gy of radiation delivered over 33 sessions. The tumor was so aggressive that changes in its volume were visually distinguishable during physical examination over a 2-week hospital stay. Histologic evaluation revealed 7 mitotic figures per high-power field. Although radiation-induced malignant fibrous histiocytoma is rare in the head and neck, the recent medical literature indicates that its incidence is rising. This rise has been attributed to the increased effectiveness of head and neck cancer therapy, which results in prolonging patients' survival and, hence, their risk of subsequent disease. Because malignant fibrous histiocytoma is a late complication of radiation therapy, appearing on average 10 years following treatment, it is important that physicians who treat head and neck cancer monitor these patients over the long term and remain alert for its appearance, even despite the apparent "cure" of their original neoplasm.- - - - - - - - - - ranking = 1keywords = physical examination, physical (Clic here for more details about this article) |
4/10. A possible case of werner syndrome presenting with multiple cancers.The treatment of a man with six metachronous primary cancers is described. The primary lesions were in the soft palate, both edges of the tongue, the hard palate, the esophagus, and the right ureter. Pathologically, all of the first five tumors in the head and neck and esophagus were proven to be squamous cell carcinoma with various grades of differentiation, and the last one was transitional cell carcinoma. The cancers were found in the early clinical stage, and were completely controlled one by one except for the ureteral tumor under treatment. His characteristic medical history and physical findings, i.e. bilateral cataracts, short stature, baldness, diabetes mellitus, high-pitched voice, and multiple malignancies, met the clinical criteria for possible werner syndrome, a genetic premature aging disorder, though the possibility of phenocopy of this syndrome has not been ruled out. We have followed him carefully because he might be vulnerable to malignant tumor formation.- - - - - - - - - - ranking = 0.10335002759212keywords = physical (Clic here for more details about this article) |
5/10. diagnosis of aseptic deep venous thrombosis of the upper extremity in a cancer patient using fluorine-18 fluorodeoxyglucose positron emission tomography/computerized tomography (FDG PET/CT).We describe a patient with a history of recurrent squamous cell carcinoma of the tongue and abnormal FDG uptake in the left arm during a re-staging FDG PET/CT. After revision of the patient's clinical history, tests and physical exam, the abnormal FDG uptake was found to correspond to an extensive aseptic deep venous thrombosis of the upper extremity.- - - - - - - - - - ranking = 0.10335002759212keywords = physical (Clic here for more details about this article) |
6/10. Oncogene probes in the diagnosis of malignant lymphoma.The authors discuss the utility of oncogene probes to differentiate a case of follicular non-Hodgkin's lymphoma from follicular lymphoid hyperplasia. The case report concerns a 50-year-old white male; physical examination revealed generalized, marked lymphadenopathy.- - - - - - - - - - ranking = 1keywords = physical examination, physical (Clic here for more details about this article) |
7/10. neurofibroma of the palatal mucosa. A case report.Neurofibromas have not been reported in the periodontal literature. In this case report, a 27-year-old female presented with a complaint of a lump in the maxillary left palatal tissue; periodontal evaluation revealed a mass 15 x 8 x 4 mm on the palatal mucosa. After removal, the region healed without recurrence. The patient was referred to her physician for a physical, and no evidence of neurofibromatosis was found elsewhere, suggesting that this case represented an example of an isolated oral neurofibroma lesion.- - - - - - - - - - ranking = 0.10335002759212keywords = physical (Clic here for more details about this article) |
8/10. Mucosal neuroma syndrome--a phenotype for malignancy.The mucosal neuroma syndrome is characterised by a typical physical appearance, neuromata on tongue and buccal mucosa, and a high risk of developing medullary thyroid carcinoma and phaeochromocytoma. A case is described and the importance of early recognition for prevention of malignancy is stressed.- - - - - - - - - - ranking = 0.10335002759212keywords = physical (Clic here for more details about this article) |
9/10. White sponge nevus. diagnosis by light microscopic and ultrastructural cytology.The lesions of white sponge nevus, an autosomal dominant abnormality of squamous epithelial differentiation that primarily affects the oral cavity, may be grossly similar to those of other hereditary mucosal syndromes, infections or preneoplastic/neoplastic processes. This differential diagnosis is best resolved in many cases by exfoliative cytology, interpreted in the context of clinical history and physical findings. The following report describes a case of white sponge nevus with typical clinical and cytologic findings, in which the diagnosis was confirmed by ultrastructural cytology. light microscopic cytology revealed parakeratotic cells and many cells containing dense eosinophilic intracytoplasmic inclusions. Electron micrographs of exfoliated cells demonstrated that these inclusions are composed of disordered aggregates of tonofilaments.- - - - - - - - - - ranking = 0.10335002759212keywords = physical (Clic here for more details about this article) |
10/10. Diffuse whitening of the oral mucosa in a child.We report a healthy 16-year-old Caucasian boy, who consulted us for white, asymptomatic lesions in the mouth. The lesions were stable and had been present for 6 years. On physical examination, there were diffuse white, soft, corrugated plaques involving the buccal and labial mucosa, oral commissures, and floor of the mouth. No other mucosae were affected and there were no skin or nail abnormalities. The histologic findings revealed epidermal hyperplasia with parakeratosis and intracellular edema in the squamous cell layer. No nuclear atypia was observed. A differential diagnosis of three entities is proposed: white sponge nevus, leukoedema, and focal epithelial hyperplasia.- - - - - - - - - - ranking = 1keywords = physical examination, physical (Clic here for more details about this article) |
| | Next -> |