Thrombosis At Unusual Sites in Reproductive Age Group-A Case Series

Thrombosis is one of the causes of morbidity and mortality in women of reproductive age group. Thrombosis at unusual sites may pose diagnostic and management dilemma for health care personnel. Teamwork and good communication provide the best modalities for maximum benefits to patients. Here with, we presented case a series of thrombosis at unusual sites seen and managed in our clinic. A 35 year-old Malay lady presented with left hemiparesis while she was on oestrogen based combined contraception pills (C-OCP). Imaging studies showed extensive venous thrombosis with bilateral acute cortical infarct. Thrombophilia screening of antiphospholipid syndrome were negative. She was put on anticoagulant and stopped 2 years after the incident. A 40 year-old Malay lady presented with abdominal discomfort, lethargy and massive splenomegaly. Bone marrow and trephine examination revealed primary myelofibrosis with positive JAK2617F. Imaging study showed chronic portal vein thrombosis with portal vein hypertension, complicated by gastro-oesophageal varices. She was put on hydroxyurea and later started on ruxolitinib with banding done over her gastro-oesophageal varices. A 26 year-old Malay lady presented with serositis, mouth ulcer and anaemia symptoms. Laboratory studies were positive for systemic lupus erythematosus and negative for antiphospholipid study. Imaging study showed long segment thrombosis of right internal jugular vein with surrounding subcutaneous oedema. She is currently stable on anticoagulants and steroid. Teamwork and holistic approach is practiced in the investigation and management to provide maximum benefits for patients.

Lipoma in Floor of Mouth.

Lipomas are adipose mesenchymal neoplasms, they are relatively uncommon in the oral cavity, representing about 0.5% to 5% of all benign oral tumors1. The clinical presentation is typically as an asymptomatic yellowish mass. The overlying epithelium is intact, and superficial blood vessels are usually evident over the tumour. We report a case with an unusual and atypical presentation of the lipomas in the floor of mouth, which is quite a rare site in the literature even in the oral cavity lipomas.

Fibroepithelial Polyps on an Unusual Genital Site during Menopausal Transition / 대한폐경학회지

Fibroepithelial polyps (FEPs) on the vulvovaginal region are rare lesions of the lower genital track and differential diagnosis can be wide. When faced with FEPs, gynecologists and pathologists have to consider a wide range of diagnoses, because overlapping morphologic features and management of these lesions has been observed. We report a case of fibroepithelial polyps that developed on an unusual genital site, and provide a brief review of the literature.

A Case of Myrmecia Occurred on the Skin of Achilles Tendon Area / 대한피부과학회지

Deep palmoplantar warts (Myrmecia), which are induced by human papilloma virus type I (HPV-1) commonly occur on the palms and soles, but occasionally are found on the lateral aspects and tips of the finger and toes. We met 12-year-old girl, who presented with round shape hyperkeratotic erythematous to brownish colored papule on the Achilles tendon area. The skin lesion was considered clinically as a verruca vulgaris, but confirmed finally as myrmecia by histopathologic findings. It is very rare and interesting case, which is presented in unusual site.

A Case of Erythema Elevatum Diutinum Developed on the Unusual Sites / 대한피부과학회지

We report a case of 77-year old male with erythema elevatum diutinum, associated with pancytopenia, which developed on the unusual sites. Erythematous or brownish nodules developed on the face, neck, trunk, upper extremities and tongue. Histopathological examination of skin and tongue lesions showed perivascular infiltration of neutrophils, lymphocytes and nuclear dusts, and deposition of fibrinoid material within and around the vessel walls. His skin lesions improved slightly with systemic corticosteroid therapy.

A Case of Cavernous Angioma of the Cerebellar Vermis

A case of cavernous angioma of the cerebellar vermis is described. Cevernous angioma is rare vascular malformation of the central nervous system and the cerebellar vermis is very unusual site. Exact preoperative diagnosis of this lesion is difficult because cavernous angioma is angiographically silent and generally accepted to be very rare. The relevant literature is reviewed.