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Hypercalcemia as a Presenting Clinical Manifestation of Adenocarcinoma of the Colon.

Hypercalcemia is rarely associated with colon cancer. It is related to overexpression of parathyroid hormone-related protein (PTH-rp) in malignant cells of the primary colon tumor and metastases. A 44 year old lady presented for evaluation of severe hypercalcemia (15.7 mg/dL) associated with abdominal pain, nausea and constipation. She was diagnosed with metastatic colon cancer involving the liver. Therapy for hypercalcemia consisted of intravenous bisphosphonate and saline hydration. Hypercalcemia remained resistant and refractory to treatment despite resection of the colon tumor. She died so

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… Physical examination revealed an obese female with blood pressue of 163/88 mmHg and epigastric tenderness to palpation. There were no palpable masses or lymphadenopathy detected. Stool guaic was negative. …

Feline infectious peritonitis.

The article discusses feline infectious peritonitis (FIP), an important disease frequently seen in veterinary practice. FIP causes many problems to the veterinarian as it can be difficult to definitively diagnose the disease, as there is no effective treatment, and as prophylactic interventions are not very successful. Although intense research has created a lot of new knowledge about this disease in the last years, there are still many unanswered questions. The objective of this article is to review recent knowledge and to increase understanding of the complex pathogenesis of FIP.

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… Fluctuation and a fluid wave may be present; in less severe cases, fluid can be palpated between the intestinal loops. Abdominal masses may sometimes be palpated, reflecting omental and visceral adhesion or enlarged mesenteric lymph nodes. … Palpation of the abdomen often reveals a thickened intestinal area. Hematology sometimes shows increased numbers of Heinz bodies, which is a result of decreased absorption of vitamin B 12 . Ocular changes Cats with FIP frequently have ocular lesions. …

A Rare Case of Papillary Thyroid Carcinoma Metastasizing to the Spine.

Papillary thyroid carcinoma (PTC) typically presents with an excellent prognosis. Distant metastasis, particularly to the spine, is rare and associated with poorer outcomes. This report highlights the importance of considering metastatic PTC in the differential diagnosis of persistent back pain in patients with thyroid abnormalities. A 61-year-old female presented with progressive lower back pain and an enlarging neck mass. Evaluation revealed a Thyroid Imaging Reporting and Data System, Category 4 (TIRADS-4) thyroid nodule and a lytic lesion in the T10 vertebra. Biopsy confirmed papillary thy

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… Further evaluation showed good power in her lower limbs and normal sensations, with no tenderness upon spinal palpation. Laboratory tests did not reveal significant abnormalities including a thyroid panel, and the workup for multiple myeloma (MM) was within normal limits (Table 1 ). …

Osteolytic lesions: Multiple myeloma or prostate cancer?

Multiple myeloma is a cancer which is characterized by proliferation of malignant B-cells and plasma cell infiltration of bone marrow. Lytic lesions are one of its hallmarks, on radiological assessment. We report 2 cases who presented within 1 year to our hospital with bony lytic lesions on CT scan. They were investigated for multiple myeloma; however, there were no further features to suggest this. Both patients were confirmed to have prostate cancer. This is unusual as prostate cancer produces sclerotic lesions (unusual hardening or thickening of the bone).

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… Patient 1 Case presentation: A 58-year-old male, with a past medical history of rheumatoid arthritis, who was diagnosed with prostate cancer following an elevated PSA level (992 ug/L) and palpation of a hard mass on the right side of the prostate, on per rectal examination. …

A rare case of oral multisystem Langerhans cell histiocytosis.

Langerhans cell histiocytosis (LCH) is a rare disorder characterized by high proliferation of Langerhans dendritic cells. LCH is a solitary or multifocal disease that primarily involves bone tissue and often affects children and young men. A 29 years-old Caucasian man was referred to the Oral Surgery Unit of George Eastman Hospital - Umberto I teaching hospital, with third degree mobility of teeth belonging to second, third and fourth quadrant. Panoramic radiograph showed multiple radiolucent areas with well demarcated borders on the right and left site of the mandible and on the left site of

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… They present themselves as ulcerated, ovoid or round lesions with erythematous, inflamed borders, painful at the palpation. Such lesions may be associated with lymphadenopathies or with cutaneous lesions. …

Induction treatment of acute myeloid leukemia in an elderly patient with intramarrow injection/administration of cytarabine: first report of a case.

We have used intramarrow injection/administration of cytarabine (Ara-C) instead of conventional intravenous approach to induce remission in an elderly patient with acute myelogenous leukemia. We show for the first time that the intramarrow injection of chemotherapeutic agents such as Ara-C can be used safely and effectively.

Relapsing polychondritis: tracheobronchial involvement and differential diagnoses.

This review is describing the diagnostic and therapeutic approach to tracheobronchial involvement in relapsing polychondritis (RP), with a focus on differential diagnoses of inflammatory origin. RP is a systemic auto-immune disease that mainly affects cartilage structures, progressing through inflammatory flare-ups between phases of remission and ultimately leading to deformation of the involved cartilages. Besides the damage of auricular or nasal cartilage, tracheobronchial and cardiac involvement are the most severe, and can seriously alter the prognosis. Tracheobronchial lesions are assesse

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… Costochondritis Costochondritis is responsible for chest wall pain, parasternal or lateral pain, or back pain for floating ribs, increasing on palpation. It can also affect ventilatory mechanisms, especially during inspiratory phases ( 16 , 17 , 20 ). … It is characterized in the acute phase, by pain on palpation or pressure, associated with redness and swelling, localized to the cartilaginous tissues, sparing the earlobe. The sequelae include damage and distortion of the auricular relief, with an aspect called “cauliflower ear” ( 15 - 18 , 21 ). …

MASTering systemic mastocytosis: Lessons learned from a large patient cohort.

BACKGROUND: Systemic mastocytosis (SM), a rare condition affecting about 32,000 individuals in the United States, is often misdiagnosed or underdiagnosed owing to its nonspecific symptoms and the need for invasive biopsies. OBJECTIVE: Our aim was to identify, classify, and characterize the natural history of patients with SM. METHODS: In a retrospective cohort study, administrative data from a large managed care organization was used to identify patients with confirmed SM, based on World Health Organization criteria. Demographic data, delay to diagnosis, disease progression, and health care

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… Hepatomegaly (without impairment of liver function) and/or palpable splenomegaly without hypersplenism or lymphadenopathy on palpation or imaging ASM SM with no associated hematologic neoplasm, and <20% mast cells in the bone marrow but with ≥1 “C” finding (ie, organ function impairment due to excessive … Hepatomegaly (without impairment of liver function) and/or palpable splenomegaly without hypersplenism or lymphadenopathy on palpation or imaging ASM | SM with no associated hematologic neoplasm, and <20% mast cells in the bone marrow but with ≥1 “C” finding (ie, organ function impairment due to excessive …

Leiomyosarcomas of the Great Saphenous Vein: Diagnostic and Therapeutic Strategies to Prevent Unplanned Excisions and Improve Oncologic, Functional, and Psychological Outcomes.

Background/objectivesThere are very few publications on unplanned excisions of great saphenous vein leiomyosarcomas (GSV-LMS), and their impact on the prognosis of the disease is not well known. The objective of this study is to present a series of nine new leiomyosarcomas of the great saphena vein (LMS-GSV) cases, with the aim of increasing diagnostic awareness and proposing guidelines for therapeutic management.MethodsThis is a prospective single-centre study of a series of nine GSV-LMS in thigh (stage IIIA AJCC), knee and proximal leg (IB, 1 II and 3 IIIA), and ankle (2 IIIB and 1 II). Eigh

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… Associated symptoms such as local discomfort ( n = 3) or pain on palpation ( n = 1) were documented. … It may also appear adherent to deep planes and be painful on palpation (tender). In the final metastatic stage, the diagnosis would be easier to make [ 11 ]. …

Редкий случай конъюнктурного уринотракса и миэломатного плеурального эфлюмилия.

ВВЕДЕНИЕ: миэломатное плевральное эфилирование (МПЭ) представляет собой редкое осложнение множественной миеломы, происходящее в < 1% - случаи, связанные с плохим прогнозом. Еще одной редкой причиной плевральной эфлуции является утечка мочи в плевральную полость, как правило, из-за обструктивной урпатии или травмы. Несмотря на то, что оба условия в индивидуальном порядке являются редкими, об их параллельных случаях ранее не сообщалось. ПРЕДОСТАВЛЕНИЕ СЛУЧАИ: 81-year-old У человека с рецидивированной множественной миеломой были диспнея, гематурия и острая почечная недостаточность. Воображение вы

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… On physical examination, the patient exhibited reduced breath sounds over the bilateral lower lobes, tenderness upon palpation over the bilateral flanks, and frank hematuria. …

A case report of metastatic hepatocellular carcinoma in the mandible and coracoid process: A rare presentation.

RationaleWe report a rare case of hepatocellular carcinoma (HCC) with metastases to the mandible and coracoid process of scapula without evidence of lung involvement.Patients concernsThe patient was diagnosed with HCC, presented 5 months later with right lower tooth pain, swelling over the right mandible area and right shoulder pain.DiagnosesHistopathological examination of mandible showed findings suggestive of metastatic HCC. Magnetic resonance imaging (MRI) of the right shoulder revealed findings of irregular enhancing lesion at the right coracoid process causing erosion of the coracoid pro

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… There was swelling over right mandible region measuring 4 × 3 cm which was firm in consistency, warm, and tender on palpation. Right submadibular lympadenopathy measuring 2 × 2 cm was present. …

Shoulder Pain in a 33-Year-Old Male Found to Have Multiple Myeloma.

Multiple myeloma (MM) is a blood cancer involving monoclonal plasma cells, mainly diagnosed in older adults. Only a very small percentage of patients are diagnosed before age 40. A 33-year-old male presented with hip and shoulder pain and was diagnosed with Immunoglobulin G (IgG) kappa multiple myeloma. Of the CRAB (calcium elevation, renal insufficiency, anemia, and bone lesions) criteria, he only exhibited anemia and bone lesions. He was found to have extensive osseous lesions throughout his skeleton and a bone marrow biopsy showing plasma cell myeloma involving 30% of medullary cellularity.

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… Physical exam revealed a bony protrusion felt on the right clavicle and tenderness to palpation of the right iliacus. …

Solitary Giant Primary Gastric Plasmacytoma Mimicking Gastric Adenocarcinoma In Situ.

A solitary extraosseous plasmacytoma is a rare type of plasma cell neoplasm. Its occurrence in the stomach is particularly unusual and can easily be mistaken for more common types of tumors. We describe a case involving a solitary extraosseous plasmacytoma in a patient who experienced weight loss as the sole symptom. Initially, the condition was misdiagnosed as gastric adenocarcinoma based on endoscopic biopsy results, leading to a gastrectomy after neoadjuvant chemotherapy. Subsequent examination of the pathological specimen revealed the presence of plasma cell neoplasia alongside a gastric a

Лактический ацидоз типа B, вторичный до метастатического рака печени в установлении нормальной функции ренального периода: доклад по делу и обзор литературы.

Лактический ацидоз происходит в результате перепроизводства лактата или уменьшения метаболизма. Она часто встречается у пациентов с критическими заболеваниями, особенно у пациентов с гематологическими заболеваниями, такими, как множественная миелома, лейкемия и лимфома. Есть. two - виды лактического кислорода, типа А и типа В, при этом тип В в гематологических условиях чаще всего представляет собой гематологические заболевания, требующие оперативного диагностики и лечения лечащего состояния. Мы представим пример 43-year-old Мужчина с раком кишечной кишки второго типа B, с метастазом к печени.

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… On examination, he was found to have tenderness to palpation in the right upper quadrant and normal respiratory effort with clear breath sounds bilaterally. The remainder of the physical examination was unremarkable. …

Indian Society of Periodontology Good Clinical Practice Recommendations for dental pain management and use of analgesics.

Pain is one of the most frequent reasons for seeking dental care and significantly influences patient comfort, treatment acceptance, and clinical outcomes. Effective management of dental pain requires accurate diagnosis, timely intervention, and the rational use of analgesics supported by evidence-based clinical decision-making. Recognizing the need for structured guidance for everyday dental practice, the Indian Society of Periodontology has developed Good Clinical Practice Recommendations on Pain Management and the Use of Analgesics in Dental Clinics. These recommendations were formulated by

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… Palpation | Define the painful area | Change in pain on pressure | Trigger points | Altered sensation 3. Musculoskeletal system | Weakness/flaccidity | Abnormal movements | Reduced light touch or proprioception | Limited range of motion 4. … With the assessment and measurement of the range of mandibular movement Palpation of soft tissue (including lymph nodes) Palpation of cervical muscles and assessment of cervical range of motion Cranial nerve examination General inspection of the ears, nose, and oropharyngeal areas Examination and palpation …

Inside-Out Repair of Medial Meniscal Ramp Lesions in Patients Undergoing Anterior Cruciate Ligament Reconstruction.

BACKGROUND: Medial meniscal ramp lesions are disruptions at the meniscocapsular junction and/or meniscotibial attachment of the posterior ho … ial incision should be facilitated by inside-out transillumination of the medial compartment and by palpation using an intra-articular probe at the medial aspect of the joint in order to avoid saphenous vein injury10.Two-thirds of the posteromedial incision should be distal to the joint line, with one-third proximal, because the suture needles often angle d …

Парастеральный перикардиоцентис для метициллина-сопротивляющегося Стафилокока ауреуса Перикардита, скомпрометированного Абсцессом и Тампонадой.

Перикардит (MRSA) является редким заболеванием и характеризуется высокой заболеваемостью и смертностью. Резюме дела: A 70-year-old Женщина с прошлым медицинским прошлым множеством миэломы, фибрилляциями, циррозом и сердечной анемией с уменьшенной фракцией выброса, покрытой болью в груди и диспной. Бактеремия MRSA из зараженного центрального венозного порта привела к септическому шоку и переднему перикардному абсцессу, что вызвало сердечный тампонад. Срочный парастеральный перикардиоцентез был выполнен, при этом флюифицированные культуры были положительными для МРСА. Несмотря на разрешение тамп

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… Outcome Postprocedurally, the patient's ICD generator site appeared erythematous, with tenderness to palpation suggesting device infection. Chest CT on day 18 displayed decreased size of the pericardial effusion and decompression of the right ventricle ( Figures 1G to 1I ). …

Acute Esophageal Necrosis: A Case Series From a Safety Net Hospital.

Acute esophageal necrosis (AEN) or "black esophagus" is a rare clinical condition, endoscopically characterized by diffuse circumferential black esophageal mucosa. Etiologies include hypoperfusion, infections, and corrosive injury. Consideration of this condition as a differential diagnosis is important, as early diagnosis and treatment has implications on survival. In this article, we present four unique cases of acute esophageal necrosis who were managed conservatively.

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… On physical examination, she had dry oral mucosa, severe epigastric and right upper quadrant tenderness to palpation. …

Multiple Bone Metastases as the First Manifestation of Hepatocellular Carcinoma in Patient with Noncirrhotic Liver.

Hepatocellular carcinoma (HCC) generally occurs on the background of chronic liver disease. Chronic hepatitides B and C and alcoholic liver disease are well-known risk factors for HCC, and it is uncommon in noncirrhotic liver. Extrahepatic metastasis seldom occurs in patients with early stage intrahepatic HCC and isolated bone metastases as a first documented extrahepatic metastasis is unusual presentation. In this report, we present a rare case of small solitary HCC (<3 cm) in noncirrhotic liver, presenting isolated bone metastases as a sole manifestation in patient with no well-known risk fa

Systemic, asymptomatic skeletal muscle infiltration by MALT lymphoma: Defining a 'silent infiltrator' phenotype with 18F-FDG PET/CT.

We report a rare phenotype of Stage IV extranodal marginal zone lymphoma (MALT lymphoma) manifesting as diffuse, asymptomatic skeletal muscle and bone marrow infiltration in a 60-year-old female. Despite a high tumor burden and intense ¹⁸F-FDG avidity (SUVmax 8.8), muscle enzymes remained normal, indicating a non-destructive "silent infiltrator" growth pattern. The diagnosis was confirmed via biopsy (CD20+, CD5-, CyclinD1-) and negative MYD88 L265P mutation status, excluding lymphoplasmacytic lymphoma. The patient achieved a Complete Metabolic Response following Bendamustine-Rituximab therapy.

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… Critically, systemic palpation identified firm, non-tender masses within both biceps’ muscles, which were synchronous findings not previously noted by the patient. There was no palpable lymphadenopathy in the cervical, supraclavicular, axillary, or inguinal regions. Hepatosplenomegaly was absent. …