RESUMO
Liposuction is a very common aesthetic procedure nowadays. The complication rate is very minimal, and it increases relatively when combined with other procedures. Infection is an expected complication in liposuction and its risk is below 1% in isolated procedures. Although the risk is very low, it might lead to fatal consequences. In this manuscript, the authors present a previously healthy female who presented to the authors' emergency department post-vibration amplification of sound energy at resonance (VASER)-assisted liposuction and lipofilling done in a private center. Her signs and symptoms started after the procedure and she visited the private center multiple times; however, no significant improvement was felt. Upon her presentation to the authors' facility, immediate resuscitation was initiated, and she was admitted for further investigations and management. Despite all resuscitation efforts and interventions, the patient's condition kept deteriorating. She was admitted to the surgical intensive care unit and taken to the operating theater twice with no observed significant improvement. The patient developed septic shock, a multiorgan failure state, followed by cardiac arrest. All resuscitation measures were taken, but the patient could not be revived and was declared dead. Early recognition of signs and symptoms of infection could be lifesaving. Aggressive resuscitation and surgical interventions (extensive debridement and antibiotics) might be necessary to produce successful outcomes.
RESUMO
Nerve sheath tumors comprise 5% of soft tissue masses of the upper limb in adults. Neurofibromas are divided into three types: localized, diffuse, and plexi- form. The diffuse type is rare and is typically found in the head and neck region. We present a rare case of diffuse type neurofibroma found in the forearm, presented to our clinic as a slowly enlarging mass of the left forearm of 3 years duration. The lesion was suspicious in the magnetic resonance imaging, and biopsy revealed diffuse type neurofibroma. We opted for total excision of the lesion that was found to be not possible due to involvement of the major nerves. The final pathology report showed no malignancy. Nerve tumors of the upper limb can be either benign or malignant. Neurofibroma associated with neurofibromatosis has malignant potential. The diffuse type is rare, and it most commonly occurs in the head and neck region. It has a low malignant transformation rate. Magnetic resonance imaging is the diagnostic modality of choice; however, it can be inconclusive. Biopsy should be taken to confirm the diagnosis and plan for management. Our case was managed by near total excision in order to preserve the major forearm nerves because of high clinical suspicion.
RESUMO
Synovial cysts are juxta-articular-fluid-filled collections that are lined by synovial cells, distinguishing them from a very close cystic lesion, which is the ganglion cyst. They usually present with pain and unpleasant appearance; here we present a case of wrist synovial cyst that caused extensor tendon rupture. A 50-year-old woman presented to our clinic with a cystic lesion on the dorsum of her wrist, with an inability to extend her index finger. The lesion was found intraoperatively engulfing the extensors of the index and causing a rupture. The cyst was excised and the tendon was reconstructed; pathology report confirmed the lesion as synovial cyst. Synovial cysts and ganglion cysts are two different entities but they have been used interchangeably in the literature; pathology is the only way to differentiate between them because they usually present with identical scenarios. None of them were reported to cause extensor tendon rupture, as presented in our article. Synovial cysts can cause rupture to extensor tendons if they arise from the sheath, and it is better to anticipate synovial cyst and remove it surgically before causing any further damage, if the lesion appeared to rise from the tendon sheath on further imaging.
