RESUMO
Toxic shock syndrome is a rare and life-threatening condition that is typically caused by group A Streptococcus or Staphylococcus aureus. It classically presents with fever, hypotension, sunburn-like rash, and multi-organ system failure. We describe a case of a 70-year-old male with this condition who had an atypical presentation of left chest wall pain and left shoulder pain after two mechanical falls along with hemodynamic stability. The patient rapidly deteriorated on his second hospital floor day, resulting in a higher complexity of care and management in the intensive care unit (ICU). Despite a number of resuscitative measures, therapies, and multidisciplinary care, the patient unfortunately passed away within 24 hours of his ICU care.
RESUMO
BACKGROUND: Gangliocytic paragangliomas are rare, and typically benign neuroendocrine neoplasms usually found in the second portion of the duodenum. Though recurrence is rare, metastatic cases have been noted. A standardized treatment has not been determined. An endoscopic resection can be carried out, unless metastasis has been noted. We present the case of a patient who underwent an ampullectomy, with successful removal of the tumor, and no recurrence on follow-up. CASE SUMMARY: We present a case involving a 58-year-old gentleman, who presented with dysphagia, and ultimately diagnosed with a periampullary mass proven to be a gangliocytic paraganglioma. The tumor was resected in-toto via an ampullectomy. The patient had no recurrence after twenty-one months. CONCLUSION: In conclusion, we present the case of an incidental gangliocytic paraganglioma occurring in the periampullary region of the patient. Ampullectomy was carried out and to date the patient has had no recurrence. Rarity of this tumor, along with treatment choice, makes it especially worthy of notability.
