RESUMEN
Gastric schwannomas (GS) are rare mesenchymal tumors from Schwann cells in the gastrointestinal (GI) tract, representing 2-6% of such tumors. We report a 52-year-old woman who experienced abdominal pain, hematemesis, and melena, initially suspected of having a GI stromal tumor through ultrasound and computed tomography abdomen. Despite no active bleeding found during an upper endoscopy, she underwent a successful open subtotal gastrectomy, with histopathology confirming GS. The diagnosis of GS, which may mimic other GI conditions, relies heavily on imaging and histopathological analysis due to its nonspecific symptomatology, including the potential for both upper and lower GI bleeding. This case underscores the diagnostic challenges of GS and highlights surgical resection as the preferred treatment, generally leading to a favorable prognosis.
RESUMEN
Undifferentiated carcinoma with osteoclast-like giant cells (UC-OGC) is a rare tumor type of pancreatic cancer. Paraneoplastic syndromes, an idiopathic inflammatory myositis characterized by various skin manifestations (such as dermatomyositis (DM)), cannot be attributed to the primary tumor itself. Here, we report an unusual case of UC-OGC presenting as a paraneoplastic syndrome, the first reported from Saudi Arabia and the Arabian Gulf states. A 49-year-old Eritrean woman with known DM was referred to our hospital with a left-sided pleural effusion. Computed tomography of the abdomen revealed a large necrotic splenic mass (~17 × 12.9 × 18.2 cm). The patient underwent exploratory laparotomy with en bloc resection of the mass (splenectomy, distal pancreatectomy, and partial excision of the left hemidiaphragm). Following a histopathological examination of the mass, UG-OGC of the pancreas, presenting as a paraneoplastic syndrome, was diagnosed. To our knowledge, this case is the first to present a paraneoplastic syndrome associated with UC-OGC. The identification of an exceedingly rare tumor presenting atypically as a paraneoplastic syndrome shows the importance of conducting comprehensive examinations of patients with malignancies, emphasizing the need for more reports of similar cases.
RESUMEN
Appendicular diverticulitis (AD) is a rare entity characterized by the inflammation of the arising diverticulum of the appendix. It has been reported to carry a high risk of perioperative complications, such as bleeding and perforation. Furthermore, multiple articles have highlighted the importance of diagnosing AD early due to its strong association with malignancies. Limited published cases concerning AD in our country and globally are available in the literature. Hence, we present in this article a case series of five exciting cases of incidental findings of AD that were initially diagnosed as acute appendicitis based on clinical evaluation and imaging findings. In our series, we performed a retrograde evaluation of the computed tomography scans of all five cases that showed diverticula. In conclusion, histopathological evaluation remains the method of choice to reach the definitive diagnosis; however, it is essential to highlight the relevance of imaging in diagnosing AD preoperatively in the early stages to reduce morbidity and mortality.
RESUMEN
Tuberculosis (TB) is an infection caused by Mycobacterium tuberculosis that primarily affects the lungs. Although TB can affect many organs, involvement of the head and neck is extremely rare and involvement of the salivary glands is even rarer. Clinical diagnosis is challenging and may be misdiagnosed, as it mimics neoplasms on physical exams and imaging. In this paper, we present a case of parotid tuberculosis in a 28-year-old man who presented with a painful left parotid mass, loss of appetite, fever, and weight loss for six months. Suspicion of infection arose, and treatment began with intravenous antibiotics, followed by oral antibiotics, with no improvement. A biopsy of the patient's left parotid gland was performed, and a diagnosis of parotid TB with jaw osteomyelitis due to Mycobacterium tuberculosis infection was made. The patient was started on isoniazid for one week, followed by isoniazid, ethambutol, and rifampicin for six months. Follow-up after six months showed full resolution of the swelling.
RESUMEN
Acute appendicitis is one of the most common surgical presentations seen in the emergency department, usually presenting as a case of fever, anorexia, and abdominal pain. Curative treatment is an appendectomy with histological examination of the surgical specimen to diagnose the subtypes or causes of appendicitis. One of these subtypes, granulomatous appendicitis, is an uncommon form of appendicitis. This condition can be caused by a multitude of mechanisms, including tuberculosis infections, parasitic infections, fungal infections, mechanical obstruction, or systemic diseases such as Crohn's disease, sarcoidosis, among others. Investigations and management should be tailored according to the histologic findings, and patient follow-up should be advised.
RESUMEN
Basidiobolomycosis is an infrequent fungal infection. It is largely a subcutaneous infection and its gastrointestinal involvement is an uncommon phenomenon. Herein, we report the case of gastrointestinal basidiobolomycosis in a 45-year-old Saudi woman who presented to the clinic with a three-week history of abdominal pain. Although infrequent, however, gastrointestinal basidiobolomycosis should be contemplated in patients presenting with abdominal pain, hematologic eosinophilia, and inflammatory gastrointestinal mass.
RESUMEN
CONTEXT: - Facebook (Menlo Park, California) is one of many online sites that provide potential educational tools for pathologists. We have each founded Facebook groups dedicated to anatomic pathology, in which members can share cases, ask questions, and contribute to discussions. OBJECTIVES: - To report our experiences in founding and maintaining these Facebook groups and to characterize the contributed content. DESIGN: - We circulated a survey among the group founders, then compiled and analyzed the responses. RESULTS: - The groups varied in membership and in the quality of member contribution. Most posts were of pathology cases, although other topics (such as research articles) were also shared. All groups remained active and received posts from users all over the world, although all groups had many noncontributing members and received unwanted messages (which were screened and removed). Most founders were glad they had founded the groups because they provided an opportunity to both teach and learn. CONCLUSIONS: - Each analyzed Facebook group had a different character, and some downsides exist, but the groups all provided a no-cost way for pathologists and others across the world to interact online with many colleagues.
