http://www.casesjournal.com The most accessed research articles published by Cases Journal 2010-02-25T00:00:00Z This is an RSS newsfeed from BioMed Central It is intended to be used with an RSS reader. For more information about RSS newsfeeds from BioMed Central, visit http://www.biomedcentral.com/info/about/rss/ IntroductionGastro-intestinal stromal tumours are the most common mesenchymal tumours of the gastro-intestinal tract. This case report highlights the necessity of early surgical intervention in such cases to avoid mortality due to rebleeding and to raise the awareness of rare causes of upper gastrointestinal bleed and their management.Case presentationA 61-year-old male presented to the accident and emergency department with a one-day history of haemetemesis with coffee ground vomiting. After initial resuscitation, he underwent upper gastrointestinal endoscopy under sedation which demonstrated a large, bleeding, gastric mass with a central crater along the greater curvature of the stomach. A partial gastrectomy was performed taking a wedge of the stomach with clearance from the tumour, with no signs of extraperitoneal disease. Conclusion: Early surgical intervention, either open or laparoscopic resection, is the treatment of choice to prevent rebleeds. In general, complete surgical resection is accomplished in 40-60% of all gastro-intestinal stromal tumours patients, and in >70% of those with primary non- metastatic gastro-intestinal stromal tumour. In our case we had completely excised the tumour. Following surgery, all patients must be referred to centres which have more experience in treating gastro-intestinal stromal tumours. Imatinib is proven to be the first effective systemic therapy in cases of unresectable or metastatic disease. All gastro-intestinal stromal tumours have the potential for aggressive behaviour with the risk being estimated from tumour size and mitotic count. http://www.casesjournal.com/content/3/1/58 Tarun Singhal Sudeendra Doddi Tessa Leake Srikanth Parsi Abdulzahra Hussain Aninda Chandra Frank Smedley Joe Ellul Cases Journal 2010, 3:58 2010-02-12T00:00:00Z doi:10.1186/1757-1626-3-58 Cases Journal 1757-1626 3 58 2010-02-12T00:00:00Z XML Seborrheic keratoses, a benign growth lesion, is a very common cutaneous lesion encountered in white races in the fourth and fifth decade. The occurrence of this lesion on the vulva is rare, as an isolated lesion or in association with lesions elsewhere. A 34-year-old woman reported with a hyperpigmented palpable lesion, approximately 5-10 mm in diameter, was found on the patient's left labium majus. The clinical differential diagnosis of the pigmented lesions of the vulva is difficult often need a biopsy. http://www.casesjournal.com/content/3/1/56 Esra Aktepe Keskin Canan Gorpelioglu Evren Sarifakioglu Hasan Kafali Cases Journal 2010, 3:56 2010-02-10T00:00:00Z doi:10.1186/1757-1626-3-56 Cases Journal 1757-1626 3 56 2010-02-10T00:00:00Z XML Pseudohyperkalemia can appear in a variety of settings and should be recognized early. Treatment of pseudohyperkalemia can lead to an inappropriate decrease of actual serum potassium levels which may lead to life threatening conditions. In the case presented, an 81-year-old male presented with massive leucocytosis and an extremely elevated potassium level. . This case report emphasizes the importance of recognizing pseudohyperkalemia in a patient with a severely increased potassium and WBC level; such patients may be clinically asymptomatic or may have a normal ECG. http://www.casesjournal.com/content/3/1/73 Alice Kim Benjamin Biteman Umer Malik Shahzad Siddique Mersadies Martin Syed Ali Nadeem Maboud Sabiya Raja Alison Zachry Ahmed Mahmoud Cases Journal 2010, 3:73 2010-02-25T00:00:00Z doi:10.1186/1757-1626-3-73 Cases Journal 1757-1626 3 73 2010-02-25T00:00:00Z PDF Community-acquired methicillin resistant Staphylococcus aureus (CA-MRSA) is considered an underreported entity in India. In this case report, the authors describe a thirty-five year old immunocompetent male presenting with severe respiratory distress requiring intubation. On further work up, a CT thorax showed features consistent with necrotizing pneumonia. The morphology and sensitivity pattern of the organism found in the bronchoalveolar lavage fluid and blood culture were consistent with MRSA. The patient's stay in the hospital was complicated by acute renal failure due to rhabdomyolysis with CPK levels of 9995 U/L. The patient was started on dialysis and improved there after. This case brings to light that CA-MRSA is becoming a problem in developing nations where antibiotics are frequently used empirically with little laboratory guidance. It also is a rare reporting of rhabdomyolysis due to CA-MRSA. http://www.casesjournal.com/content/3/1/61 Poorani Goundan Anurag Mehrotra Deepa Mani Indumathy Varadarajan Cases Journal 2010, 3:61 2010-02-14T00:00:00Z doi:10.1186/1757-1626-3-61 Cases Journal 1757-1626 3 61 2010-02-14T00:00:00Z XML We report a rare case of late knee locking after an open knee injury in a polytrauma patient with a pelvic fracture and a contralateral femoral artery injury. Once the life and limb threatening injuries were addressed, debridement and washout of the knee wound was performed. X-rays and subsequent CT revealed only an undisplaced patella fracture. The patient presented 6 months later to a knee surgeon with recurrent locking. An arthroscopy was performed and a 10mm plastic soft drink bottle cap was retrieved leading to the immediate resolution of symptoms without complications.Open knee injuries require thorough debridement washout and joint assessment. Late locking should raise the suspicion of an intra-articular loose or foreign body. Arthroscopy is an excellent first line tool in the diagnosis and late management of this unusual problem. http://www.casesjournal.com/content/3/1/72 Simon Boyle Joseph Talbot Quamar Bismil Ernest Schilders Cases Journal 2010, 3:72 2010-02-24T00:00:00Z doi:10.1186/1757-1626-3-72 Cases Journal 1757-1626 3 72 2010-02-24T00:00:00Z PDF Authors describe a case of recurrent exfoliative cheilitis that responded to treatment with a standardized topical preparation of Calendula officinalis L. An eighteen-year-old man was referred to UNESP - São Paulo State University, Department of Biosciences and Oral Diagnosis, São José dos Campos Dental School to investigate a chronic dry scaling lesion on his lips. The patient's main chief was aesthetic compromising. Corticoid therapy was suspended and Calendula officinalis ointment 10% for ad libitum use has been prescribed. The results presented allow the authors to consider Calendula officinalis L. as a potential therapy in cases of cheilitis exfoliative. http://www.casesjournal.com/content/2/1/9077 Lucia Helena Denardi Roveroni-Favaretto Karina Bortolin Lodi Janete Dias Almeida Cases Journal 2009, 2:9077 2009-11-23T00:00:00Z doi:10.1186/1757-1626-2-9077 Cases Journal 1757-1626 2 9077 2009-11-23T00:00:00Z XML IntroductionStiff limb syndrome is a clinical feature of the stiff person syndrome, which is a rare and disabling neurologic disorder characterized by muscle rigidity and episodic spasms that involve axial and limb musculature. It is an autoimmune disorder resulting in a malfunction of aminobutyric acid mediated inhibitory networks in the central nervous system. We describe a patient diagnosed by neurological symptoms of stiff limb syndrome with a good outcome after treatment, and a review of the related literature.Case presentationA 49-year-old male patient presented with a progressive stiffness and painful spasms of his both legs resulting in a difficulty of standing up and walking. The diagnosis of stiff limb syndrome was supported by the dramatically positive response to treatment using diazepam 25 mg/day and baclofen 30 mg/day. Conclusion: This clinical case highlights the importance of a therapeutic test to confirm the diagnosis of stiff limb syndrome especially when there is a high clinical suspicion with unremarkable electromyography http://www.casesjournal.com/content/3/1/60 Abderrazak Hajjioui Karima Benbouazza Mohamed El Alaoui Faris Amina Missaoui Najia Hajjaj Hassouni Cases Journal 2010, 3:60 2010-02-12T00:00:00Z doi:10.1186/1757-1626-3-60 Cases Journal 1757-1626 3 60 2010-02-12T00:00:00Z XML Cancer survivors have a higher risk of new primary cancer, in the same or in another organ, than the general population. We report a 78-year-old women who has metachronous quadruple adenocarcinoma, includes bilateral breast cancer, ovarian cancer and retroperitoneal neuroendocrine carcinoma. The development of second cancer in cancer survivors can be expected but third or higher order malignancies are rare. http://www.casesjournal.com/content/3/1/53 Umut Demirci Ugur Coskun Pinar Uyar Gocun Bahar Gurlek Burcu Saka Banu Ozturk Mustafa Benekli Suleyman Buyukberber Cases Journal 2010, 3:53 2010-02-08T00:00:00Z doi:10.1186/1757-1626-3-53 Cases Journal 1757-1626 3 53 2010-02-08T00:00:00Z XML This case report describes a 13-year-old boy with alveolar bony defect resulted from surgical removal of impacted upper canine transposed in the anterior region. The boy had a normal occlusion with malposition of upper central and lateral incisors. The treatment objectives were to align teeth, close spaces by mesial movement of the buccal segments in the upper jaw to repair bone loss. Fixed appliance with palatal root torque was used for the mesial movements, levelling, and alignment of teeth.Orthodontic tooth movement consisted of a sequence of root movement in a direction to increase the thickness of the labial cortical plate of bone, could ensure healthier periodontium. A healthier periodontium prior to space closure ensured repair of alveolar bony defect after surgical intervention. Orthodontic tooth movement should be added to our armamentarium for the repair of alveolar bony defect. http://www.casesjournal.com/content/3/1/62 Wai Yip Lei A Bakr Rabie Ricky Wong Cases Journal 2010, 3:62 2010-02-15T00:00:00Z doi:10.1186/1757-1626-3-62 Cases Journal 1757-1626 3 62 2010-02-15T00:00:00Z XML Giant tonsillolith is a rare clinical entity. Commonly, it occurs between 20–77 years of age. We had a twelve years old female patient, who had odynophagia due to a giant tonsillolith. The stone was removed and tonsillectomy was performed. We reviewed the literature on this rare clinical entity and found that this is the fourth case of giant tonsillolith in a child and largest ever tonsillolith to be reported in English literature. http://www.casesjournal.com/content/1/1/50 Jagdeep Thakur Ravinder Minhas Anamika Thakur Dev Sharma Narinder Mohindroo Cases Journal 2008, 1:50 2008-07-18T00:00:00Z doi:10.1186/1757-1626-1-50 Cases Journal 1757-1626 1 50 2008-07-18T00:00:00Z XML