Isolated Internal jugular vein thrombosis as the first presentation of gastric adenocarcinoma

Internal jugular vein [IJV] thrombosis is a very rare vascular disease that is usually the result of trauma, infectious disease, and central vein thrombosis. Malignancy, either known or occult, is an uncommon etiology of IJV thrombosis. The presented patient was a 49-year-old woman who suffered from painful swelling in the right side of her neck. Physical examination revealed a painful and immobile mass in the right side of her neck. Doppler ultrasonography scan showed thrombosis of the right IJV. Initial workups to find malignancy were unremarkable. She underwent treatment by intravenous heparin and antibiotics and her symptoms resolved after one week. Six months later, the patient presented once more with repeated vomiting and epigastric pain. On gastroesophageal endoscopy, a mass in the lesser curve of the stomach was detected

The pathology report was compatible with gastric adenocarcinoma. Association between IJV thrombosis and some malignancies [e.g., lung and lymphoma] have been reported. IJV thrombosis can be the first presentation of malignancy. IJV thrombosis should be kept in mind in patients with painful swelling in the neck and long- term follow-up to exclude any malignant diseases is recommended

[ case report of acute gouty arthritis in a young patient with type 1 glycogen storage disease]

Glycogen storage disease [GSDs] comprise several rare inherited diseases caused by abnormalities of enzymes that regulate the synthesis of Glycogen. A- 26 years old man admitted to the hospital because of pain and swelling in his ankles. Also, he had delay of puberty. In diagnostic evaluation, the patient had hyperuricemia, hyperlipidemia and adenomatous nodules in the liver. Liver biopsy revealed Glycogen storage disease type 1. gouty arthritis in glycogen storage disease is not uncommon; however, glycogen storage disease as a reason of gouty arthritis is rare. Because of growth failure, delayed puberty and laboratory results we strongly suspected to an underlying disease as a cause of hyperuricemia and gouty arthritis leading to glycogen storage disease diagnosis