ABSTRACT
ABSTRACT Background: Thymolipoma is a rare benign tumour of the mediastinum, accounting for 2%-9% of all thymic tumours. Although many case reports have been published in the literature, few studies have analysed the clinical and radiological features and the surgical outcomes of this tumour. Objective: To evaluate the clinical and radiological features and the surgical outcomes of the patients with thymolipoma. Methods: We reviewed the records of the Pathology Department from the beginning of 2005 to the end of 2013. Results: We identified 11 patients with thymolipoma. There were eight male and three female patients. Their ages ranged from 27 to 72 years, with the mean age of 40 years. All patients described pulmonary or extrapulmonary symptoms. Two patients (18.2%) had myasthenia gravis. Chest X-ray was normal in four patients. Computed tomography of the thorax revealed a mass located in the anterior mediastinum in all patients. It showed fat attenuation in 4 of 11 patients (36.4%). Thymectomy was performed in all patients. The surgical approach was thoracotomy in five, sternotomy in four and video-assisted thoracic surgery in two patients. Thymolipomas ranged in size from 4 to 33 cm. One patient died 2 years after surgery. None of the remaining patients had evidence of recurrence on follow-up. Conclusion: Thymolipoma is a rare tumour of the thymus. It may be associated with myasthenia gravis. Surgical resection is the treatment of choice in the patients with thymolipoma. Complete surgical resection is the cure in most patients.
ABSTRACT
Reactive arthritis is defined as arthritis that occurs during or after an extraarticular infection. It is mostly difficult to determine the causative agent that causes inflammation in the joints. Initially, salmonella, shigella, chlamydia and Yersinia were considered to be pathogenic agents. But recently, in addition to demonstrated viral and bacterial agents, there are also other cases of reactive arthritis after vaccinations with Rubella and Influenza. Herein a 3-year old boy is reported with reactive arthritis of left knee that developed shortly after hand-foot and mouth disease. This report represents the first detailed description of a paediatric case in literature with reactive arthritis following hand-foot and mouth disease
ABSTRACT
Pneumococcal meningitis does continue to be an important cause of mortality and morbidity in childhood despite widespread vaccination. It develops thorough invasion of the meninges by the agent via bloodstream. It may manifest typical signs of meningeal irritation and even the symptoms not belonging to the central nervous system, such as diarrhea. The diagnosis is made by microscopic evaluation and culture of cerebrospinal fluid (CSF) obtained by lumbar puncture. Despite the treatment, the risk of occurrence of cerebral and neurologic complications is high. A two-month old baby girl was presented to our outpatients’ clinic because of fever and diarrhea; she was diagnosed with pneumococcal meningitis and developed cerebral infarct during surveillance. The reason why we presented this patient is to highlight that meningitis due to pneumococ, one of the most common causing agents in childhood meningitis, may have clinical presentations other than expected.
ABSTRACT
A 47-year-old woman was diagnosed with secondary progressive multiple sclerosis, and was treated with intrathecal morphine for chronic pain via a slow-release subcutaneous pump. She accidentally received a 35-ml (510 mg) bolus injection of morphine by this route, which led to status epilepticus. She was treated with continuous intravenous naloxone infusion, and with medication to control hypertension and stop the seizure activity. The outcome was excellent, and the patient returned to her neurological baseline. This report describes the complications and the successful treatment of intrathecal morphine overdose. In order to prevent these serious errors, it is vital that only care providers who are proficient with these devices perform the refilling procedure.