Rare case of mortality after hemorrhagic property of esthesioneuroblastoma.

Esthesioneuroblastoma is a tumor arising from olfactory neuroepithelium with an incidence of four per million. This case presents a rare nasal cavity neoplasm with hemorrhagic properties that may lead to significant sequelae. We present a 69-year-old male patient who presented with worsening altered mental status over the past 6-7 months. His Glasgow coma scale was a nine, showing a large mass centered at the cribriform plate with extension intracranially, sinonasal cavity, and bilateral orbits on diagnostics. Bifrontal craniotomy was performed one day after admission with resection of the tumor in the cranial fossa and intranasally, and decompression of the brainstem, frontal lobes, and third ventricle. After surgery, the patient was managed in the intensive care unit but continued to deteriorate. He was confirmed to have no meaningful brain activity and eventually deceased seven days after admission. Depending on the tumor stage, esthesioneuroblastoma can have a favorable prognosis with proper therapies. Different surgical techniques for ENB lead to the question of which therapeutic modality is the best because of the tumor's gross hemorrhagic properties. With adjunctive radiation therapy and/or chemotherapy, more research can bring light to proper surgical techniques.

Ortner's syndrome: A rare case of hoarseness secondary to chronic aortic dissection.

Ortner's syndrome, also known as cardiovocal syndrome, is a rare presentation of aortic dissection. Symptoms occur as a result of recurrent laryngeal nerve compression. Our report describes a case of a patient who complained of hoarseness for a few months and was eventually diagnosed with chronic aortic dissection.

Ashwagandha as a Unique Cause of Thyrotoxicosis Presenting With Supraventricular Tachycardia.

Ashwagandha root extract (ARE) is a reputed herbal supplement in Ayurvedic medicine for a variety of health conditions. To date, scant attention has been paid to thyrotoxicosis associated with Ashwagandha and it is rarely reported in the literature. We report a 73-year-old female who presented with supraventricular tachycardia, symptoms of hyperthyroidism and significantly low TSH levels, after two years of using ARE as a self-administered treatment for hypothyroidism. Full symptomatic resolution and biochemical improvement ensued upon cessation of the supplement. Though the pathophysiology remains obscure, we hope to promote awareness concerning this rare yet possible side effect of Ashwagandha.