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Case Report: Repot of Huge Primary Mediastinal Carcinoid Tumors with Horsiness

Manouchehr Aghajanzadeh*, Alirza Jafanegad2, Ali alive MD, Omid mosafaii, Yasaman Safarpoure and Samman Ayobi

A carcinoid tumor can occur in a variety of sites, including the mediastinum. Carcinoid tumor arising from the mediastinum is invariably related to the thymus. Isolated origin of mediastinal carcinoids is rare, especially in the posterior mediastinum. Only two cases of posterior mediastinal carcinoids have been reported so far. These were assumed to be arising from ectopic thymus tissue. We report a case of a 48-year-old man who presented with dyspnoea, horsiness and dry cough due to giant carcinoid tumor of the posterior mediastinum, the pedicle originating from the posterior mediastinum, not related to the thymus. She underwent thoracotomy and resection that provided relief. The Microscopic and immunochemical studies revealed extrathymic and show more pronounced cytologic atypia, increased mitotic activity (approximately 3-/ 410 HPF), Grade II) Grade II or (intermediate grade neuroendocrine neoplasm (a typical carcinoid).

Cite this Article: Aghajanzadeh M, Jafanegad A, Alive A, Mosafaii O, Safarpoure Y, et al. Repot of Huge Primary Mediastinal Carcinoid Tumors with Horsiness. SRL Case Rep Short Rev. 2017;3(2): 016-018.

Published: 21 February, 2017

Case Report: Hypoplastic Long Head of Biceps Brachii Muscle: Three Case Reports with Clinical Implications and Literature Review

Alexandar Iliev, Georgi Kotov, Boycho Landzhov, Iva N. Dimitrova and Georgi P. Georgiev*

Biceps brachii is one of the most variable muscles in the human body and multiple variations have been described of its origin, number and morphology of the heads. In the present study, we describe three cases of hypoplasia of the long head of biceps brachii, one observed bilaterally and one observed in only one arm. We also make a brief literature review of other reported variations. Hypoplasia of the long head of biceps brachii can present with swelling in the anterolateral aspect of the lower part of the brachium during flexion of the elbow, thus simulating a muscle rupture. It can also increase the risk of shoulder instability and cause difficulties during arthroscopy of the shoulder joint. Due to the fact that routinely used imaging modalities, such as ultrasound, MRI and MR arthrograms cannot always distinguish the presence of biceps brachii variations, their incidence, appearance and clinical significance should be borne in mind by orthopaedicians and surgeons in order to avoid misdiagnosis and unnecessary surgical interventions.

Cite this Article: Iliev A, Kotov G, Landzhov B, Dimitrova IN, Georgiev GP. Hypoplastic Long Head of Biceps Brachii Muscle: Three Case Reports with Clinical Implications and Literature Review. SRL Case Rep Short Rev. 2017;3(1): 013-015.

Published: 20 February, 2017

Case Report: Acquired Angioedema and Large Granular T-Cell Leukemia

Massimiliano Postorino*, Livio Pupo, Maria Domenica Guarino, Federico Meconi, Benedetta Mariotti, Vito Maria Rapisarda, Jacopo Giammatteo, Marta Della Torre, Roberto Perricone, Maria Cantonetti and Giovanni Del Poeta

Acquired Angioedema (AAE) is a rare syndrome due to an acquired deficiency of C1 inhibitor (INH), enzyme involved in the regulation of C1 factor activity. C1-INH deficiency leads to C4 and C2 components depletion, while the terminal complement components remain normal.

Cite this Article: Postorino M, Pupo L, Guarino MD, Meconi F, Mariotti B, et al. Acquired Angioedema and Large Granular T-Cell Leukemia. SRL Case Rep Short Rev. 2017;3(1): 010-012.

Published: 20 February, 2017

Opinion: Nivolumab in Cancer Patients: Why OS and not PFS Matters

Reyad Dada*

We are entering new era of treating cancer patients with chemotherapy free protocols. Recently, several published clinical study results demonstrated clinical efficacy of single agent nivolumab in pretreated cancer patients. Ferris and colleagues published recently results of nivolumab in patients with recurrent head and neck cancer [1].

Cite this Article: Dada R. Nivolumab in Cancer Patients: Why OS and not PFS Matters. SRL Case Rep Short Rev. 2017;3(1): 008-009.

Published: 16 February, 2017

Case Report: Repair of a Recurrent Direct Inguinal Hernia in a Patient with a History of Mesh Infection

Danielle A. Cunningham* and Robert Weidling

While inguinal hernia repair is among the most commonly performed surgical procedures, little data exists to guide the management of a patient with a recurrent inguinal hernia following mesh excision performed for mesh infection. Arguments exist for whether or not to utilize mesh again in this population, with the most common pro-prosthesis position being that, following mesh excision, the defect tends to be large, and would be difficult to approximate without significant tension without use of a prosthesis. A common argument against mesh use in this population is that the patient's history of mesh infection increases their risk of future mesh infection.
A 39-year-old gentleman presented with a three week history of a bulging right-sided groin mass. In 2009, the hernia was repaired laparoscopically with mesh, and in 2010, the patient had a mesh infection, following which the mesh was excised in an open surgery. The patient was asymptomatic for five years, until he experienced symptomatic recurrence of his hernia. The decision was made to repair the hernia in an open technique with mesh. This case exemplifies the current debate on the use of mesh in patients with recurrent inguinal hernia following mesh excision for mesh infection.

Cite this Article: Cunningham DA, Weidling R. Repair of a Recurrent Direct Inguinal Hernia in a Patient with a History of Mesh Infection. SRL Case Rep Short Rev. 2017;3(1): 005-007.

Published: 08 February, 2017

Case Report: Aprepitant in Emesis Induced by Leptomeningeal Carcinomatosis: Case Report and Rationale

Lamberti G*, Minichillo S, Zamagni C, Biasco G

Introduction: We report the case of a young woman affected by emesis refractory to antiemetic drugs, but that temporarily responded to aprepitant, and the possible biological rationale.
Case Report: A 37-year-old woman affected by breast cancer presented with worsening pulsating headache. Leptomeningeal metastases were diagnosed and she rapidly developed nausea and vomiting. Vomiting was unresponsive to antiedemigen and specific antiemetic treatment. Patient underwent chemotherapy administration and aprepitant was given as off-label CINV prevention therapy. The following 6 days were characterized by complete control of vomiting (no episodes, no rescue therapy). After that time vomiting resumed.
Discussion: We hypothesize that the emesis-free period in the patient was due to aprepitant action at a level in emetic circuitry different from other drugs previously administered that had proved ineffective. Our hypothesis is supported by a biological, anatomic and functional rationale in preclinical and clinical studies, which are presented, and by another analogue report in literature.
Conclusion: Aprepitant might have a role in management of emesis from causes other than CINV, within both the palliative and supportive care setting. Further proof-of-concept investigation is needed.

Cite this Article: Lamberti G, Minichillo S, Zamagni C, Biasco G. Aprepitant in Emesis Induced by Leptomeningeal Carcinomatosis: Case Report and Rationale. SRL Case Rep Short Rev. 2017;3(1): 001-004.

Published: 05 January, 2017

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