Cells Gone Wild: A Case Report on Missed Acute Leukemia and Subsequent Disseminated Intravascular Coagulation in the Emergency Department.

INTRODUCTION: Emergency physicians must maintain a broad differential when seeing patients in the emergency department (ED). Occasionally, a patient may have an undiagnosed, life-threatening medical condition not related to the presenting chief complaint. It is imperative to review all ordered laboratory tests and any available previous laboratory values to assess for any abnormalities that may warrant further evaluation. CASE REPORT: This case report is regarding the missed diagnosis of acute leukemia and subsequent disseminated intravascular coagulation in a 27-year-old male who presented to multiple EDs with the unrelated chief complaint of finger ring entrapment. This patient ultimately succumbed to his illness. CONCLUSION: When evaluating patients in the ED, it is important to review any prior available test results for abnormalities, even if the results do not specifically correlate with the chief complaint. Emergency physicians must remain vigilant to avoid missing a critical diagnosis.

Extensive Presentation of Penile Carcinoma Cuniculatum a Variant of Squamous Cell Carcinoma With Low Malignant Potential.

Carcinoma cuniculatum is an uncommon variation of squamous cell carcinoma (SCC) has been documented in a few cases at various locations of the body such as penis, foot, jaw, oropharynx and esophagus. In this case, a 79-year-old male presents with a penile mass, which he underwent a total penectomy. Histology of the mass was defined as carcinoma cuniculatum with negative margins and no lymphovascular invasion. This variant of SCC rarely metastasizes. A joint decision was made to observe lymph nodes. It is important to differentiate the different SCC because patient care can be guided based on the pathology.