ABSTRACT
Glomus tumor (glomus cell tumor) is a rare, often benign neoplasm, which is, in most cases, seen as a solitary bluish nodule involving the nail beds. Solid glomus tumor, glomangioma, and glomangiomyoma are the three main histopathological variants. In this case report, we present the rarest subtype of a glomus tumor, glomangiomyoma, in an atypical location: the stomach. A 45-year-old female from Syria presented to the clinic with severe dizziness and left epigastric abdominal pain accompanied by melena. We performed a thorough clinical study, laboratory workup, upper gastrointestinal endoscopy, endoscopic ultrasound, CT scan, as well as macroscopic and microscopic histologic examination of the surgical specimen, in addition to the immunohistochemical staining. Although rare, gastric glomangiomyoma was diagnosed and a 4.5 × 3 × 3 cm soft tissue mass was resected from the gastric antrum, and no clinical or endoscopic evidence of recurrence was observed for the follow-up duration of 4 years. Undiagnosed gastric lesions with unexplained symptoms should be further investigated and not be disregarded immediately. To the best of our knowledge, this is only the second report of an instance of gastric glomangiomyoma.
ABSTRACT
Hepatitis A is a common viral illness worldwide. It usually results in an acute, self-limiting disease and only rarely leads to fulminant hepatic failure or any other complications. During the period of conflict in Syria, and due to the damages to water infrastructure and poor sanitation, a dramatic increase in hepatitis A virus infection has been documented. Here we report a rare case of a 14-year-old male whose hepatitis A was complicated with hepatorenal syndrome and subacute liver failure. The war condition in Syria impeded transportation of the patient to a nearby country for liver transplantation, contributing to his unfortunate death.
Subject(s)
Esophagoscopy/methods , Foreign-Body Migration/diagnosis , Foreign-Body Migration/therapy , Laryngeal Neoplasms/surgery , Laryngectomy/methods , Laryngectomy/rehabilitation , Larynx, Artificial/adverse effects , Equipment Failure , Follow-Up Studies , Humans , Laryngeal Neoplasms/diagnosis , Male , Middle Aged , Risk Assessment , Speech, Esophageal , Treatment Outcome , Vocal Cords/pathologyABSTRACT
Biopsies from short segments of columnar appearing mucosa in the distal esophagus often fail to reveal intestinal metaplasia (IM). The yield of IM on repeat upper endoscopy (EGD) and biopsy in these patients is not known. Our aim was to prospectively evaluate the yield of IM on repeat EGD in patients with suspected SSBE (negative for IM on first EGD). Forty-three patients with suspected SSBE underwent repeat EGD with biopsy. This included 42 men and 1 woman, mean age 53 years (range: 45-90) with a mean columnar mucosa length of 1.26 cm (range: 0.5-2.5). On repeat EGD, 10 of 43 patients (23.2%) had evidence of IM. There was no statistically significant difference between the patients with proven SSBE on repeat EGD compared to those with persistent negative IM with regards to age, ethnicity, length of columnar mucosa, GERD symptoms, and hiatal hernia size. In conclusion, more than 20% of patients with suspected SSBE have evidence of IM (ie, proven SSBE) on repeat EGD. Thus repeat EGD with biopsy may be warranted in patients with tongues of columnar mucosa in the distal esophagus but no IM on the first biopsy to confirm the diagnosis of SSBE.