Résumé
Diabetic muscle infarction (DMI) is an uncommon complication in patients with diabetes and it tends to be underdiagnosed, or misdiagnosed, clinically. Recently, we experienced a case of recurrent diabetic muscle infarction that was unusual in that the patient was younger than other patients. The patient was a 21-year-old woman with a 9-year history of maturity-onset diabetes of the young (MODY) who was referred to our department complaining of pain and edema in her right thigh. Magnetic resonance imaging (MRI) showed an increased T2-weighted signal and edema in the affected muscle. The final diagnosis was DMI. However, when the patient had partially recovered and was receiving supportive care, she had a second attack on the other side of the same leg during her hospitalization, in spite of her blood glucose level being strictly controlled. We report the clinical characteristics and imaging findings of this patient with recurrent DMI.
Sujets)
Femelle , Humains , Glycémie , Complications du diabète , Diabète de type 2 , Oedème , Hospitalisation , Infarctus , Jambe , Imagerie par résonance magnétique , Muscles , Récidive , CuisseRésumé
Due to the increased prevalence of papillary thyroid carcinoma (PTC), difficult cases and unexpected events have become more common during long-term follow-up. Herein we reported four cases that exhibited poor progress during long-term follow-up. All the cases were diagnosed with PTC and treated with total thyroidectomy before several years, and the patients had been newly diagnosed with recurrent and metastatic PTC. These four cases included recurred PTC with invasion of large blood vessels, a concomitant second malignancy, malignant transformation, and refractoriness to treatment. Physicians should closely monitor patients to promptly address unforeseen circumstances during PTC follow-up, including PTC recurrence and metastasis. Furthermore, we suggest that the development of a management protocol for refractory or terminal PTC is also warranted.
Sujets)
Humains , Vaisseaux sanguins , Carcinomes , Études de suivi , Métastase tumorale , Seconde tumeur primitive , Prévalence , Récidive , Glande thyroide , Tumeurs de la thyroïde , ThyroïdectomieRésumé
Due to the increased prevalence of papillary thyroid carcinoma (PTC), difficult cases and unexpected events have become more common during long-term follow-up. Herein we reported four cases that exhibited poor progress during long-term follow-up. All the cases were diagnosed with PTC and treated with total thyroidectomy before several years, and the patients had been newly diagnosed with recurrent and metastatic PTC. These four cases included recurred PTC with invasion of large blood vessels, a concomitant second malignancy, malignant transformation, and refractoriness to treatment. Physicians should closely monitor patients to promptly address unforeseen circumstances during PTC follow-up, including PTC recurrence and metastasis. Furthermore, we suggest that the development of a management protocol for refractory or terminal PTC is also warranted.