RESUMEN
A 71-year-old male initially presented with vocal cord palsy and underwent tracheostomy. After thorough examination, urogenital dysfunction, orthostatic hypotension, and Parkinsonism were found, which led to the diagnosis of multiple system atrophy (MSA). After the tracheostomy, bi-level positive airway pressure ventilation was required during the night due to nocturnal hypoxemia. Night-time hypoxemia is related to central sleep apnea, which is one of the manifestations of MSA. This is the first case of MSA manifested by bilateral vocal cord palsy as an initial sign in Korea. This case supports the notion that MSA should be taken into consideration when vocal cord paralysis is observed.
Asunto(s)
Anciano , Humanos , Masculino , Obstrucción de las Vías Aéreas , Hipoxia , Diagnóstico , Hipotensión Ortostática , Corea (Geográfico) , Atrofia de Múltiples Sistemas , Trastornos Parkinsonianos , Apnea Central del Sueño , Traqueostomía , Ventilación , Parálisis de los Pliegues VocalesRESUMEN
We report a case of duodenal metastasis from squamous cell carcinoma of the cervix confirmed by histopathological diagnosis. A 48-year-old woman was diagnosed with uterine cervix cancer stage IVB and underwent chemotherapy. During follow-up after chemotherapy, a mass suspicious of malignancy was found at the 3rd portion of the duodenum on the magnetic resonance imaging of the abdomen. Esophagogastroduodenoscopy with biopsy was done for an ulcerofungating mass at the 3rd portion of the duodenum. Squamous cell carcinoma was confirmed on the biopsy which was same as the histopathological diagnosis confirmed by cervix biopsy and right supraclavicular lymph node biopsy resulting from metastasis of cervix. Since 1981, only ten cases of small bowel metastasis from squamous cell carcinoma of cervix have been reported. It is exceedingly rare to find metastasis to the duodenum from uterine cervix cancer.
Asunto(s)
Femenino , Humanos , Persona de Mediana Edad , Abdomen , Biopsia , Carcinoma de Células Escamosas , Cuello del Útero , Diagnóstico , Quimioterapia , Duodeno , Endoscopía del Sistema Digestivo , Estudios de Seguimiento , Ganglios Linfáticos , Imagen por Resonancia Magnética , Metástasis de la Neoplasia , Neoplasias del Cuello UterinoRESUMEN
Pseudoxanthoma elasticum (PXE)-like disorder with multiple coagulation factor deficiency is a genetic disease characterized by dystrophic mineralization of the connective tissue in multiple organs such as the skin, arteries, and retina. Patients with this disorder have excessive folding and sagging of the skin with loss of recoil, as well as coagulopathy. Crohn's disease is a chronic inflammatory condition of the gastrointestinal tract, which primary affects the small intestine, often leading to malnutrition. Here, we describe the case of a 25-year-old woman who presented with these diseases. We found that nutrient deficiency due to long-term Crohn's disease aggravated the coagulopathy associated with PXE-like disorder.
Asunto(s)
Adulto , Femenino , Humanos , Arterias , Factores de Coagulación Sanguínea , Tejido Conectivo , Enfermedad de Crohn , Tracto Gastrointestinal , Intestino Delgado , Desnutrición , Seudoxantoma Elástico , Retina , PielRESUMEN
A 71-year-old male initially presented with vocal cord palsy and underwent tracheostomy. After thorough examination, urogenital dysfunction, orthostatic hypotension, and Parkinsonism were found, which led to the diagnosis of multiple system atrophy (MSA). After the tracheostomy, bi-level positive airway pressure ventilation was required during the night due to nocturnal hypoxemia. Night-time hypoxemia is related to central sleep apnea, which is one of the manifestations of MSA. This is the first case of MSA manifested by bilateral vocal cord palsy as an initial sign in Korea. This case supports the notion that MSA should be taken into consideration when vocal cord paralysis is observed.