Background: Periarteritis nodosa (PAN) is a necrotizing systemic vasculitis involving mediumsized arteries and rarely the smallsized ones. It affects various organs and is generally revealed by different non specific ...Background: Periarteritis nodosa (PAN) is a necrotizing systemic vasculitis involving mediumsized arteries and rarely the smallsized ones. It affects various organs and is generally revealed by different non specific organs. The aim of the authors is to report a rare revealing manifestation of this disease which is the perforation of the small bowel and to highlight the most important histological features. Case report: The authors describe the case of a 48-year-old Caucasian woman, without a particular past medical history, who presented an acute surgical abdomen. A surgical exploration was decided and showed a necrosis of the small bowel and the appendix. A segmental ileectomy was performed. The histological examination of the specimen showed small vasculitis-affected with fibroid necrosis dealing to the diagnosis of intestinal perforation caused by a PAN was retained. Post-operatively, the patient was put on immunosuppressive therapy and presented a prolonged healing process and was discharged from the hospital 20 days after her admission. Conclusion: Although it is rare for PAN to be revealed by small bowel perforation, it should be kept in mind when facing ischemic change of the small bowel.展开更多
Spinal intradural mature teratomas are rarely encountered in adults.In this report,one of the oldest patients ever reported to harbor an intradural mature teratoma of the conus medullaris is presented,and the relevant...Spinal intradural mature teratomas are rarely encountered in adults.In this report,one of the oldest patients ever reported to harbor an intradural mature teratoma of the conus medullaris is presented,and the relevant literature concerning the teratoma’s origin,clinical presentation,radiological features,and treatment modalities is reviewed.A previously healthy 70-year-old woman presented with a 2-month history of left sciatica.Her neurological examination was normal and the magnetic resonance imaging of the thoracolumbar spine showed an intradural,partially cystic mass extending from T12 to L3 level.The patient underwent a T11-L4 laminectomy.After opening the dura,a yellowish vascular tumor attached to the conus medullaris came into view.Meticulous dissection allowed for subtotal tumor removal.Only a thin part of the tumor wall,tightly attached to the conus medullaris,was left.The tumor was diagnosed as mature teratoma by histological study,and no adjunctive therapy was administered.The pain experienced by the patient disappeared postoperatively.Her condition remained unchanged with no radiological recurrence through the most recent follow-up examination,3 years after surgery.The present study outlines that mature teratoma can arise from the conus medullaris,even in older adult patients.Functional preservation is of utmost importance,and long-term follow-up is mandatory to spot recurrences early.展开更多
文摘Background: Periarteritis nodosa (PAN) is a necrotizing systemic vasculitis involving mediumsized arteries and rarely the smallsized ones. It affects various organs and is generally revealed by different non specific organs. The aim of the authors is to report a rare revealing manifestation of this disease which is the perforation of the small bowel and to highlight the most important histological features. Case report: The authors describe the case of a 48-year-old Caucasian woman, without a particular past medical history, who presented an acute surgical abdomen. A surgical exploration was decided and showed a necrosis of the small bowel and the appendix. A segmental ileectomy was performed. The histological examination of the specimen showed small vasculitis-affected with fibroid necrosis dealing to the diagnosis of intestinal perforation caused by a PAN was retained. Post-operatively, the patient was put on immunosuppressive therapy and presented a prolonged healing process and was discharged from the hospital 20 days after her admission. Conclusion: Although it is rare for PAN to be revealed by small bowel perforation, it should be kept in mind when facing ischemic change of the small bowel.
文摘Spinal intradural mature teratomas are rarely encountered in adults.In this report,one of the oldest patients ever reported to harbor an intradural mature teratoma of the conus medullaris is presented,and the relevant literature concerning the teratoma’s origin,clinical presentation,radiological features,and treatment modalities is reviewed.A previously healthy 70-year-old woman presented with a 2-month history of left sciatica.Her neurological examination was normal and the magnetic resonance imaging of the thoracolumbar spine showed an intradural,partially cystic mass extending from T12 to L3 level.The patient underwent a T11-L4 laminectomy.After opening the dura,a yellowish vascular tumor attached to the conus medullaris came into view.Meticulous dissection allowed for subtotal tumor removal.Only a thin part of the tumor wall,tightly attached to the conus medullaris,was left.The tumor was diagnosed as mature teratoma by histological study,and no adjunctive therapy was administered.The pain experienced by the patient disappeared postoperatively.Her condition remained unchanged with no radiological recurrence through the most recent follow-up examination,3 years after surgery.The present study outlines that mature teratoma can arise from the conus medullaris,even in older adult patients.Functional preservation is of utmost importance,and long-term follow-up is mandatory to spot recurrences early.
