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Sarcomas are a rare and fatal treatment complication following radiotherapy. Radiation-induced sarcomas (RISs) presenting as a gluteal abscess is a rarity, accounting for its varied presentation. We present a case of a middle-aged woman, post-chemo-radiation for carcinoma cervix 5 years ago, who presented with gluteal abscess. Achieving haemostasis post incision and drainage under anaesthesia was a challenge. On further evaluation, she was diagnosed with radiation-induced gluteal soft tissue sarcoma. Haemostasis was achieved after radiation following failed attempts of surgical and radiological interventions. She is currently planned for chemotherapy. Cancer survivors have an increased risk of developing a second malignancy following radiation treatment. RISs are highly aggressive, exhibit a varied clinical presentation and pose a challenge in early diagnosis; thus, have a poor outcome. RISs pose a diagnostic challenge; any dubious lesion in the previously irradiated field should raise suspicion and prompt aggressive management.Mucoepidermoid carcinomas (MECs) are the most common malignant tumour of the salivary glands. MECs have also been reported to occur in atypical sites. Primary MECs of the thyroid gland are extremely rare, accounting for 0.5% of thyroid malignancies with approximately 48 cases reported in the literature. In most cases, these are low-grade neoplasms with good long-term prognosis. We present the case of a 74-year-old patient with poorly differentiated MEC of the thyroid gland, which behaved aggressively resulting in rapid decline and death of the patient. The exact pathophysiology of the disease remains unclear and there is no consensus on the optimal treatment for this histological subtype. Recognition and diagnosis of this rare neoplasm are important as this can help guide optimal treatment, although in high-grade poorly differentiated cases, treatment options remain limited.Acrokeratosis paraneoplastica (Bazex syndrome) is a rare paraneoplastic skin condition characterised by acral psoriasiform plaques, with a predilection for the nose, ears, hands and feet. It typically presents before the discovery of an internal malignancy and is often misdiagnosed as an inflammatory dermatitis that does not respond to treatment. It is associated with squamous cell carcinoma of the aerodigestive tract and lung, as well as adenocarcinoma of the lung, colon and gastrum. Here, we describe the second reported case of Bazex syndrome in the setting of pancreatic adenocarcinoma and the first such case in a patient of African ancestry.Myiasis by Oestrus ovis, the zoonotic infestation with Diptera larvae, primarily diagnosed in goats and rams in tropical and Mediterranean countries, is an uncommon disease in humans; indeed, literature data are still lacking. Nevertheless, few cases of human myiasis have been reported, leading to benign or severe complications. Here, we report a rare case of human rhinomyiasis detected in Northern Italy. A 39-year-old Italian woman, returning from vacation in Corsica, showed several sinusal symptoms and progressive asthenia and was therefore admitted at the Otorhinolaryngology Unit of Biella Hospital, Italy. Endoscopic examination of the nasal cavity revealed some formations, morphologically identified as O. ovis larvae. The patient then underwent endoscopic sinus surgery, followed by complete resolution of symptoms. this website Clinical presentation, diagnostic work-up and therapeutic procedures have been compared with few other cases found in the literature.A 75-year-old female patient presented with signs and symptoms of a right hemispheric syndrome. A CT scan of the brain with angiogram showed an acute infarct in the right middle cerebral artery (MCA) territory secondary to thromb-occlusion of the M1 segment of the right MCA. A follow-up CT scan 2 weeks later showed a large hyperdense region in the infarcted area. With the aid of a dual-energy CT scan, this was eventually shown to be due to contrast staining from an earlier administration of iodinated contrast on the same day, rather than frank haemorrhagic conversion of the recent right MCA infarct.In this case, we present an uncommon gastrointestinal infection in an immunocompromised patient that was solely diagnosed because of close collaboration between treating physicians and microbiologists. The patient is a 42-year-old male who underwent heart transplantation 5 years earlier. He presented with fever, weight loss, diarrhoea and tiredness. Initial investigations could not elucidate the aetiology of his symptoms. The patient was referred to the department of infectious diseases for further evaluation. Serology for Yersinia species was ordered and the result was suggestive for the possibility of a Yersinia species infection. Close collaboration between treating physicians and microbiologists followed and led to additional investigations, which revealed the diagnosis of a Yersinia pseudotuberculosis infection with extensive lesions in the gastrointestinal tract. Treatment with ciprofloxacin resulted in complete resolution of symptoms and healing of the gastrointestinal lesions. In conclusion, this case underlines the need for a multidisciplinary approach to complex patients of which symptoms have yet to be understood.We present a 9-year-old male child having history of fractures on trivial trauma with a family history of the same. He was treated for osteogenesis imperfecta (OI; zolendronate, calcium and vitamin D) and showed clinical improvement. On evaluating his bone health using dual energy X-ray absorptiometry and peripheral quantitative CT, we found that the child had bone density within the reference range but a smaller bone mass for his height, low muscle mass and thin bones with a lower strength strain index in comparison with healthy children. Our case suggests that treatment with bisphosphonates results in increase in bone density; however, bones remain thin and the lean body mass in these children may also be low. Controlled physical activity to improve muscle health and newer approaches to improve bone geometry would result in better bone health in children with OI.
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