A Rare Case of a Spontaneous Thoracic Epidural Hematoma in a Young Male Weightlifter.

Spontaneous spinal epidural hematoma (SSEH) is the accumulation of blood in the epidural space of the spinal cord. Acute SSEH is a rare phenomenon that presents with a wide variety of neurologic symptoms and most often is a surgical emergency. We present a previously healthy 34-year-old male with sudden onset progressive weakness and tingling in the right lower extremity that progressed to the left lower extremity while bench pressing weights, resulting in complete lower extremity paralysis. Magnetic resonance imaging (MRI) revealed a 3.0 cm extradural mass centered in the dorsal and left lateral canal. After a T1-T4 hemilaminectomy was performed which was followed by inpatient rehabilitation, the patient had a favorable outcome improving from The American Spinal Injury Association Impairment Scale (AIS) grade A, complete impairment, to AIS grade C, incomplete impairment on discharge. Initially, the patient had complete motor and sensory paralysis below the level of T4, and upon discharge, the patient was able to attain modified independence in activities of daily living, mobility, and transfer. Due to the lack of risk factors for SSEH in this patient, the etiology is most likely related to the Valsalva maneuver while weightlifting. Lesions in the thoracic region with rapid progression of neurologic symptoms are indicators of poor prognosis, so this case highlights the importance of prompt recognition and intervention for improved outcomes to prevent devastating neurologic defects.

Extra-Ocular Sebaceous Carcinoma Unveiled: A Case Study of Dermal Challenges in an Elderly African American Patient.

Sebaceous carcinoma is a rare malignant tumor of the sebaceous glands that most commonly presents in the periocular area. Uncommon extraocular manifestations are occasionally observed, often limited to the head or neck but can occur wherever sebaceous glands are found. There are increasing cases of sebaceous carcinoma in the United States which continue to pose ongoing diagnostic challenges. We present a patient with a 5.5 x 4 x 2 cm gradually growing necrotic and fungating upper back mass, present for one year. This lesion was initially diagnosed as an excoriated sebaceous adenoma, microscopically showing well-formed organoid structures and no irregular infiltration into the dermis, but was later confirmed as sebaceous carcinoma, demonstrating prominent mitosis and infiltrative growth pattern, following wide surgical excision. Margins were clear following the surgery with no signs of recurrence but further treatment recommendations included follow-up with oncology due to the rarity and aggressive nature of this tumor. This case serves to present an atypical presentation of a rare malignancy that has an increased occurrence rate for unknown reasons.

Novel Anti-Melanoma Compounds Are Efficacious in A375 Cell Line Xenograft Melanoma Model in Nude Mice.

Despite the successes of immunotherapy, melanoma remains one of the deadliest cancers, therefore, the need for innovation remains high. We previously reported anti-melanoma compounds that work by downregulating spliceosomal proteins hnRNPH1 and H2. In a separate study, we reported that these compounds were non-toxic to Balb/C mice at 50 mg/kg suggesting their utility in in vivo studies. In the present study, we aimed to assess the efficacy of these compounds by testing them in A375 cell-line xenograft in nude athymic mice. Animals were randomized into four groups (n = 12/group): 10 mg/kg vemurafenib, and 25 mg/kg 2155-14 and 2155-18 thrice a week for 15 days along with a control group. The results revealed that both 2155-14 and 2155-18 significantly decreased the growth of A375 tumors, which was comparable to vemurafenib. These results were confirmed by tumor volume, weight, and histopathological examination. In conclusion, these results demonstrate the therapeutic potential of targeting spliceosomal proteins hnRNPH1 and H2.