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Gangliocytic Paraganglioma of the Appendix; A Rare Case Report and Review

Gangliocytic paraganglioma (GP) (nonchromaffin paraganglioma, paraganglioma) is a morphologically distinct tumor most commonly occurring in the second part of the duodenum in the proximity of ampulla of Vater. We herein, present a case report of appendiceal mass in a 16-year-old male who presented with recurrent right iliac fossa pain and steno sing cecal tumor on CT abdomen. He underwent right hemicolectomy and histopathological examination of appendix showed infiltration of appendiceal wall with gangliocytic paraganglioma. To our knowledge this is the first reported case of gangliocytic paraganglioma of appendix in our area.
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An Unexpected Diagnosis of Plasmacytoma of The Thyroid: A Case Report and Review of The Literature

Plasmacytoma is a malignant proliferation of plasma cells that can arise in the bone marrow (osseous) and in the soft tissues. Extramedullary plasmacytomas most commonly occur in the upper respiratory tract. Thyroid involvement is rare. In this report, we describe a new case plasmacytoma of the thyroid gland in a 60-year-old man with a history of multinodular goiter present for several years and an unexpected rapid increase of the mass associated to dysphagia, dyspnea, and dysphonia. Histopathological examination of surgical specimen, along with immunohistochemical studies, unexpectedly led to the diagnosis of plasmacytoma. We also briefly summarize the last 30 years of literature on thyroid plasmacytoma and review the salient characteristics of this rare condition.
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Case Report: De novo Ocular Myasthenia Gravis after the mRNA Vaccine for SARS-COV2

Autoimmune Myasthenia gravis is a neuromuscular junction disease caused by destruction of the acetylcholine receptor on the postsynaptic membrane, mediated by autoantibodies and clinically characterized by skeletal muscle weakness. This can be triggered by drugs, infections, and in rare cases by vaccines. During the COVID pandemic, de novo cases and exacerbations of myasthenia gravis due to viral infection have been documented. Although few cases related to COVID vaccination. A 69-year-old female patient with blurred vision, a clinic that began 10 days later after receiving first dose of COVID vaccine, and diplopia and right palpebral ptosis after the second dose, 30 days later. In the examination, Edrophonium test was clearly positive, treatment with pyridostigmine and prednisone was started and after 14 days the clinic showed improvement until the resolution of the symptoms There are few reports of exacerbations or triggers for the appearance of myasthenia gravis, a series of 27 cases has been published where there are outbreaks of immune-mediated diseases or the new appearance of autoimmune diseases, in which it is observed that the time of appearance of the outbreak was on average 4 days up to a maximum of 25 days. In conclusion, Myasthenia gravis is a rare complication of the BNT162b2 COVID-19 vaccine. Its potential severity and the current lack of knowledge of the real incidence after vaccination makes it necessary to maintain an attitude of vigilance in the face of symptoms that suggest it.
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An Unusual Lesion on The Palate: A Rare Case Report

Minor salivary glands are present in most parts of the mouth. They are the important components whose secretion directly bathe the tissues of the oral cavity. Smoking is the most commonly seen deleterious habit among men which directly affects minor salivary glands in the palate. Smoking also causes stomatitis nicotina in the oral cavity.
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Progressive Supranuclear Palsy with Classic Radiological Signs: A Case Report and Literature Review

Progressive supranuclear palsy (PSP) is a rare neurodegenerative parkinsonian syndrome with distinct clinical features which tends to be progressive, causing vertical supranuclear gaze palsy, frontal lobe cognitive decline, postural instability and progressive axial rigidity. Clinical examination typically reveals ocular motor dysfunction including restricted vertical gaze, slow vertical saccades and “eyelid opening apraxia” with intact vestibule ocular reflex. PSP falls under the rubric of Parkinsonism plus syndromes that are a group of heterogeneous degenerative neurological disorders that differ from the classical idiopathic Parkinson’s disease. PSP is often underreported, making it important for clinicians to be aware of this disorder. Here we report a case of PSP, which presented primarily with speech disturbances and recurrent falls due to postural instability. On investigating, the magnetic resonance imaging (MRI) revealed a classical sign diagnostic of PSP. This teaching case report describes management and prognosis of the disease
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Gliomatosis Cerebri: A Case Report

Background: Gliomatosis cerebri is a rare primary brain tumor that can have extensive infiltration into the brain parenchyma. It can affect any age group and often has poor clinical outcomes. Given its unique pathology, presentation and treatment can be challenging to recognize and efficaciously treat
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A Case Report: Delayed Onset Urinary Tract Injury after Laparoscopic Hysterectomy

Lower urinary tract injury in hysterectomy is rare, but once it occurs, the consequence can be deteriorating. We experienced late onset urinary tract injury that developed as late as 15 days after laparoscopic hysterectomy. The objective of this case report is to alert all gynecological laparoscopists that such late onset complication may happen to any of patients.
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Solitary Adrenal Metastasis: A Case Report of Aberrant Behavior of Prostate Cancer

A Caucasian male with prostate cancer under androgen deprivation therapy after radiotherapy for a locally advanced lesion. Positron emission tomography/Computed Tomography revealed an adrenal lesion. The mass was removed, and histopathological examination showed adenocarcinoma of prostatic origin. Prostate-specific antigen decreased dramatically after adrenalectomy
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A Case Report of Peripheral Giant Cell Granuloma

Peripheral giant cell granuloma (PGCG) is a rarely seen benign lesion at soft oral tissue. In this report, the patient had a history of central giant cell granuloma at the left mandibular posterior region. The lesion was excised two years ago. Patient was consulted to our hospital for soft tissue growth at right maxillary anterior region. Excisional biopsy was planned and the lesion was examined histopathologically. Giant cell reparative granuloma was described and routine examination was advised to the patient
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A Novel Coenzyme Q8A Mutation in a Case with Juvenile-Onset Coenzyme Q10D4: Case Report and Literature Review

Primary coenzyme Q10 deficiency-4 (CoQ10D4) is an autosomal recessive disorder characterized by childhood-onset of cerebellar ataxia and exercise intolerance. Molecular pathology responsible for clinical findings is mitochondrial respiratory chain dysfunction. The main clinical manifestation involves early-onset exercise intolerance, progressive cerebellar ataxia and movement disorders. Some affected individuals develop seizures and have mild mental impairment, indicating variable severity.
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Treatment of Erdheim-Chester Disease with High Dose Pegylated IFN-α: a Case Report and Literature Review

Erdhein-chester disease is a rare non-Langerhans histocytes that can involve multiple systems, with bone involvement as the most common. We reports a 39-year-old female who visited the hospital due to pain in both lower limbs, combined with clinical manifestations, imaging, and laboratory tests, Erdhein-Chester disease was prelimi narily diagnosed. The diagnosis was confirmed by the presence of BRAF V600E mutation and tissue cells on biopsy of the right tibia. We discussed the disease based on literature review, aiming to improve the understanding of clinicians.
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Disseminated Blastomycosis: A Case Report

Blastomycosis is known for its propensity to mimic other illnesses, which often leads to incorrect or delayed treatment. Here we present a case report of a patient working in Wisconsin who was misdiagnosed as Tuberculosis since he was an Indian. The patient was not evaluated on endemic grounds for Blastomyces where he was working for couple of years. After he developed skin lesions along with increased shortness of breath, lesions were evaluated which showed large yeast cells resembling Blastomyces. The treating pulmonologist evaluated his occupational history and was revealed with endemicity for Blastomyces.
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A Case Report of Diffuse Ischemic Injury from Leptomeningeal Midline Glioma Metastases

Diffuse midline gliomas with the histone 3-lysine-27-methionine (H3K27M) mutation should be considered in the differential diagnosis of recurrent hemiparesis and headache in patients with midline brainstem lesions, even with the absence of contrast-enhancement. Early diagnosis is essential for prognostication and engagement in trials evaluating novel therapeutics such as ONC-201.
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Late Benign Gastrobronchial Fistula after Esophagectomy for Esophageal Cancer: A Case Report

Benign gastrobronchial fistula (GBF) is extremely rare but highly fatal complication of esophagectomy for upper gastrointestinal system cancers. We present a benign GBF after three years esophagectomy for esophageal cancer with presenting recurrent pneumonia. We choose wedge bronchoplasty without lobectomy and primary repair of gastric conduit as an approach.
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Fulminant Emphysematous Pyelonephritis: Case Report and Revision of the Literature

A 56-year-old woman with type 2 diabetes mellitus and multiple sclerosis presented to our emergency department with right flank pain, fever (38.6°) and dysuria. A computed tomography (CT) scan showed the right kidney hydronephrosis secondary to ureteral stone, therefore a percutaneous nephrostomy was placed. The next day the patient’s condition deteriorated rapidly; a new CT showed the presence of gas in the right kidney suspicious for emphysematous pyelonephritis (EPB) that needed an emergency nephrectomy. Thirtyfive days later the patient was discharged in good general condition.
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Editorial Board Members Related to case report

Norio Yasui-Furukori

Associate Professor
Department of Neuropsychiatry
Hirosaki University School of Medicine
Japan

GIUSTI CRISTIANO

Professor
Department of Ophthalmology
University Hospital “Campus Bio-Medico”
Italy

Norio Yasui-Furukori

Associate Professor
Department of Neuropsychiatry
Hirosaki University School of Medicine
Japan

Vikram Khanna

Orthopedic Surgeon
Ranjana Hospital
Allahabad

Adam Reich

Professor
Department of Dermatology
University of Rzeszow
Poland
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