A 5-Year-Old Female With an Aneurysmal Bone Cyst of the Proximal Humerus.

An aneurysmal bone cyst (ABC) is a non-malignant, skeletal tumor that is extremely rare and most commonly presents within the first two decades of life. Genetic mutation of the USP6 gene on chromosome 17 remains to be the most commonly accepted reasoning as ABC's etiology remains unknown. As the radiographic appearance of ABC is quite similar to other kinds of bone cysts, a histological diagnosis is often required to attain a definitive diagnosis. Curettage remains the gold standard treatment with high chances of local recurrence. Evidence has shown the beneficial applications of administering a sclerosing agent. Further trials would improve the level of evidence available for physicians to make a better management plan. We have demonstrated the treatment of an aneurysm bone cyst of the proximal humerus on a 5-year-old female in this report, which might be utilized as a reference for future procedures.

A Rare Case of Sheehan Syndrome With Cardiac Tamponade.

Sheehan syndrome, also called postpartum hypopituitarism, is primarily caused by ischemic necrosis of the pituitary resulting from a complicated pregnancy. As the clinical presentations occur years after the complication, it is difficult to diagnose this condition. In this report, we discuss the case of a 35-year-old female with altered mental status, generalized edema, and loss of appetite. The condition was complicated due to the comorbidities of multiple medical conditions such as massive pericardial effusion and untreated jaundice. Her anorexic condition perfectly masked the malnourished appearance of the patient. After multiple laboratory tests and diagnostic imaging, the empty sella turcica of the patient propounded Sheehan syndrome. Replacement of the deficient hormones improved her condition after two weeks. Patients with complicated pregnancy history should be advised for diagnostic imaging early in life to appropriately manage Sheehan syndrome. A delay in diagnosis can have significant health and financial loss. Hormone replacement therapy is the only viable option as there is no cure to treat necrosed pituitary.

Spontaneous Coronary Artery Dissection in Patients With Fibromuscular Dysplasia.

Clinicians must be mindful of angiographic appearances in patients with spontaneous coronary artery dissection (SCAD) in the setting of fibromuscular dysplasia (FMD) for the timely management of these high-risk patients. The objective is to highlight the clinical diagnostic and treatment modalities in rare case presentations of patients presenting with concurrent SCAD and FMD presentation. A qualitative review of scholarly materials. Twenty-seven patients who presented with a combination of SCAD and FMD from January 1, 2009, to August 2019 were identified. Various demographics such as age, gender, FMD location, acute-phase treatment (i.e., percutaneous coronary intervention (PCI) vs. coronary artery bypass grafting (CABG) vs. conservative), treatment outcomes, and then grouped into two tables. The mean age >46 years and standard deviation (SD) were used to calculate the normal distribution and percentile used to calculate others for treatment. SCAD and FMD cases were collected from three search engines ranging between 2009 and 2019. 22% of the patients had coronary artery disease (CAD). Additionally, 44.4% representing 12 patients with ST-segment elevation acute myocardial infarction (STEMI), four patients 14.8% presented with a non-ST-segment elevation myocardial infarction (NSTEMI), and nine patients 33.33% offered with unstable angina. Besides, 13 patients were diagnosed with optical coherence tomography (OCT), while intravascular ultrasound (IVUS) diagnosed six patients. SCAD is still very rare compared to other causes of myocardial infarction. Data has shown that up to 25% of acute coronary syndrome (ACS) cases of women between 40 and 65 years are SCAD.