Melphalan Culprit or Confounder in Acute Encephalopathy during Autologous Hematopoietic Stem Cell Transplantation?

We report a case of a female patient with Durie-Salmon stage 3A/ISS stage I IgG kappa multiple myeloma (MM) who developed encephalopathy after high-dose melphalan and hematopoietic stem cell transplant (HSCT). The most common etiologies for encephalopathy such as infection, narcotic medications, metabolic-electrolyte disturbance, stroke, and central nervous system (CNS) hemorrhages were ruled out. The patient recovered from the altered mental status spontaneously. The possibilities of melphalan-induced encephalopathy versus critical-state delirium versus hypercytokinemia induce encephalopathy were contemplated.

Metastatic extra-abdominal presentation of gastrointestinal stromal tumors in a young Hispanic male: a case presentation and literature review.

This article presents the medical history and management of a 44-year-old Hispanic male with metastatic extra-abdominal gastrointestinal stromal tumor including a literature review on this rare clinical presentation.

Hispanic with a primary pulmonary angiosarcoma: case report and literature review.

We report the case of a male Hispanic patient with a left lower lung mass that invaded the left pulmonary vein associated with left intra atrial tumor mass extension. Pathology diagnosis was consistent with an Angiosarcoma that upon correlation with pattern of growth and dissemination, was considered to be of lung origin. Angiosarcoma is a malignant tumor derived from vascular endothelial cell and accounts for 1% of adult's soft tissue sarcomas. Pulmonary Angiosarcomas are usuaIly secondary tumors with less than twenty cases described in the medical literature.

Rare benign breast tumor.

We report the case of a female patient with an incidental finding at routine mammography evaluation which consisted of a benign spindle cell tumor, namely Breast Myofibroblastoma. It is arranged in fascicles with interspersed broad bands of hyalinized collagen with variable immunohistochemical reactivity to desmin, vimentin, smooth muscle actin and CD 34. It is usually not reactive to cytokeratins and S-100 as seen in the myoepitheliomas. Recurrence of the lesion after excisional surgical procedure is not documented at medical literature. It is important to recognize the benign nature of this neoplasm to prevent extensive mutilating surgical procedures.

An unusual presentation of alveolar hemorrhage.

We report the case of a female patient with an atypical case of alveolar haemorrhage secondary to disseminated strongyloidiasis. Although uncommon, clinicians should consider the diagnosis of pneumonia by disseminated strongyloidiasis in patients with endemic exposure to Strongyloides stercoralis who present with symptoms of cough, wheezing, and dyspnoea. Primary care physicians should strongly consider screening for strongyloidiasis in patients from endemic areas prior to considering the use of steroids or any other immunosuppressants. The best screening test would be serological testing.