Staged Management of Intracranial Masson Tumor: An Unexpected Gauntlet: Case Report and Review of the Literature.

BACKGROUND: Intravascular papillary endothelial hyperplasia (IPEH), also known as Masson tumor, is a benign lesion consisting of a reactive proliferation of endothelial cells with papillary formations related to thrombi. It has been reported in many different anatomic areas. Gross total resection is the elected treatment. Intracranial IPEH is rare, and only a few cases have been reported. This article reports a complicated case of cavernous sinus Masson tumor. CASE DESCRIPTION: A 51-year-old woman presented because of hemicraneal headache, left facial paresthesia, and diplopia (due to a slight left ocular external rectum muscle paresis) that she had experienced the previous 60 days. She had previously received a diagnosis of neurofibromatosis type I. Contrast-enhanced magnetic resonance imaging showed a 3.5-cm contrast-enhanced tumor adjacent to the left cavernous sinus involving the Meckel cave that extended around the distal petrous portion of the left internal carotid artery. Two possibilities as a differential diagnosis were suggested: meningioma or neurogenic tumor. After a staged surgical procedure, the histopathologic findings were unexpected and showed IPEH (Masson tumor) as the cause of the mass. Despite having benign features, the IPEH showed recurrences over time, so adjuvant 3-dimensional conformal radiation therapy was initiated. CONCLUSIONS: IPEH is prone to recurrences after subtotal resection. In the present case, successful surgical treatment and adjuvant radiotherapy showed an excellent outcome. To date, no adjuvant therapy has been established as a go-to option.

Mesenteritis esclerosante relacionada con IgG4, una entidad rara causante de dolor abdominal / IgG4-related sclerosing mesenteritis, a rare condition that causes abdominal pain

La distinción de la enfermedad relacionada con IgG4 como una entidad inmunomediada que engloba patologías consideradas clásicamente como idiopáticas ha supuesto una revolución en el algoritmo diagnóstico y terapéutico en diferentes especialidades médicas. Esta entidad suele implicar a diversos órganos (la afectación de un órgano aislado, a excepción del páncreas, es infrecuente), lo cual determina unos hallazgos histopatológicos característicos. Presentamos el caso de un paciente valorado por dolor abdominal que, tras estudio exhaustivo y habiendo descartado otras etiologías, fue diagnosticado de mesenteritis esclerosante IgG4 cumpliendo criterios radiológicos e histopatológicos (AU)

The identification of IgG4-related disease as a distinct immune-mediated condition encompassing disorders that were traditionally seen as idiopathic has been a revolution in the diagnostic and therapeutic algorithm in several medical fields. This condition usually involves multiple organs (isolated organ involvement is uncommon except in the pancreas) with characteristic histopathological findings. We report a case that was assessed due to abdominal pain and subsequently diagnosed with IgG4-related sclerosing mesenteritis. A comprehensive work-up of the case ruled out other conditions and a diagnosis of IgG4-related sclerosing mesenteritis was made according to radiographic and histopathological criteria (AU)

IgG4-related sclerosing mesenteritis, a rare condition that causes abdominal pain.

The identification of IgG4-related disease as a distinct immune-mediated condition encompassing disorders that were traditionally seen as idiopathic has been a revolution in the diagnostic and therapeutic algorithm in several medical fields. This condition usually involves multiple organs (isolated organ involvement is uncommon except in the pancreas) with characteristic histopathological findings. We report a case that was assessed due to abdominal pain and subsequently diagnosed with IgG4-related sclerosing mesenteritis. A comprehensive work-up of the case ruled out other conditions and a diagnosis of IgG4-related sclerosing mesenteritis was made according to radiographic and histopathological criteria.

Enfermedad venooclusiva hepática inducida por hierbas medicinales chinas / Hepatic veno-occlusive disease induced by Chinese medicinal herbs

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Hepatic veno-occlusive disease induced by Chinese medicinal herbs.

The potential hepatotoxic effects of products containing medicinal herbs, which are increasingly used without adequate control by health authorities, is well known. We report a case of toxic hepatic veno-occlusive disease (HVOD) presumably associated with the use of such herbal remedies.

Colestasis canalicular inducida por anabolizantes esteroideos / Canalicular cholestasis induced by anabolic steroids

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Canalicular cholestasis induced by anabolic steroids.

Inappropriate use of anabolic steroids is increasing, usually by younger males in an illicit manner. This is a well-documented case of cholestatic hepatitis attributed to use of anabolic steroids for esthetic and/or athletic purposes.