Internal medicine
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Pott's puffy tumor is a rare complication of frontal sinusitis characterized by frontal bone osteomyelitis with a subperiosteal abscess typically presenting with forehead swelling. We herein report a 21-year-old man with Pott's puffy tumor presenting as eyelid swelling on the opposite side of the sinusitis, without typical forehead swelling. Initially treated for sinusitis and pre-septal cellulitis with poor response, head magnetic resonance imaging revealed bilateral subdural abscesses and osteomyelitis of the frontal and bilateral parietal bones, leading to the diagnosis. When frontal sinusitis and eyelid swelling are unresponsive to antibiotics, Pott's puffy tumor should be considered, even in the absence of forehead swelling.
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A Southeast Asian man in his 30s residing in Japan developed severe disseminated strongyloidiasis during long-term steroid therapy. Initially misdiagnosed as gastroenteritis, his condition was later identified as strongyloidiasis by fecal smears and endoscopy. ⋯ This case underscores the importance of considering the patient's geographical background and immunosuppressive history in medical assessments. It further highlights the need for early and proactive diagnostic approaches, such as stool testing and gastrointestinal endoscopy, to effectively detect and treat imported infectious diseases.
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Case Reports
A Case of Superficial Primary Malignant Melanoma of the Esophagus Detected and Treated at Stage 0.
The patient was a 79-year-old male. At three years and eight months after his initial presentation, upper gastrointestinal endoscopy revealed a black-flattened elevated lesion in the middle third of the esophagus, which was diagnosed as malignant melanoma on biopsy. No lymph node or distant metastasis was found. ⋯ The postoperative diagnosis was pT1a-MM, N0, M0, vascular invasion+, stage 0. The patient was recurrence-free for 14 months after surgery. We presume that an aggressive biopsy diagnosis is important for the early detection of malignant melanoma.
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Case Reports
A Cerebral Embolism Caused by a Malignant Peripheral Nerve Sheath Tumor in a Patient with Neurofibromatosis Type 1.
A 31-year-old man with neurofibromatosis type 1 (NF-1) had undergone resection of a malignant peripheral nerve sheath tumor (MPNST) on the buttock 3 months previously. He subsequently underwent mechanical thrombectomy for a hyperacute left middle cerebral artery embolism. ⋯ The patient died of respiratory failure due to lung MPNST metastasis on day 15 of hospitalization. To our knowledge, this is the first report of a spontaneous cerebral embolism due to MPNST in an NF-1 patient.