Category Archives: Case Report

Tumors of the Oro-Facial System

Biriş Carmen1, Brînzaniuc Klara2, Cerghizan Diana1, Jánosi Kinga1, Kovács Alpárd3

1 Department of Prosthetic Dentistry and Oral Rehabilitation, University of Medicine and Pharmacy, Tîrgu Mureș, Romania
2 Department of Anatomy and Embriology, University of Medicine and Pharmacy, Tîrgu Mureș, Romania
3 Dentist in private practice

The increasing number of malignant cases in the oro-facial area represents by their increasing number lately a new problem regarding the treatment and diagnosis. This cases present an increased difficulty of diagnostic and treatment, because they are usually diagnosticated in lately stages. Patients are often unaware of the gravity of their situation due to the lack of specific or almost absent symptomatology.
The incriminated factors and co-factors incriminated in the development of the malignant manifestations are of multiple origins: use of tobacco products, especially associated to alcohol abuse, chronical topic irritation of the oral mucosa, genetic predisposition or some types of viruses (human papilloma virus type 16 and 18 and herpes virus). Also factors like: environmental modifications, age, alimentation or pharmaceutical drug usage can be incriminated for the increasing pathology of the last decades, especially in well developed countries both from Europe and North America.
Our presentation is based on the case of a 61 years old male, showing almost the typical premises of a malignant pathology starting from the evolution of the oral lesion and the general and dental pathology status with the correlation of the objective and subjective examination.
The lesion usually benefits of surgical treatment, followed by radiotherapy and oro-facial reconstruction, that can imply both plastic surgery and prosthetic rehabilitation, as was the case of our patient. Of most importance remains the moment of the prosthetic treatment and its correlation with radiotherapy, regarding the tissue modification that irradiation has on this level.

Keywords: , , , , ,
Full text: PDF

Remarks on Odontogenesis in Children After Chemo-radiation Therapy

Bică Cristina1, Chinceşan Mihaela2, Păcurar Mariana¹, Molnár Enikő³, Stolnicu Simona4

1 Department of Pediatric Dentistry, University of Medicine and Pharmacy, Tîrgu Mureș, Romania
2 Department of Pediatric Haematology-Oncology, University of Medicine and Pharmacy, Tîrgu Mureș, Romania
3 Emergency County Hospital, Tîrgu Mureș, Romania
4 Department of Pathology, University of Medicine and Pharmacy, Tîrgu Mureș, Romania

Introduction: Leukemias are the most frequent forms of neoplasias in children. The oral complications that occur in time, after the specific treatment through chemotherapy or radiotherapy, are represented by the occurrence of multiple carious lesions, disorders of dental eruptions, the premature loss of the primary teeth, anomalies in the development of teeth.
Material and method: Through the clinical examination of the oral cavity and through radiological examination, with the help of the orthopantomogram, we revealed the disorders of dental development consecutive to the cytostatic therapy and radiotherapy in the acute lymphoblastic leukemia.
Results: The specific treatment through chemotherapy and radiotherapy overlapped with important stages of the physiological process of odontogenesis. We noted ageneses, microdontias, precocious eruptions and disorders of the eruption order.
Conclusions: The cytostatic medication and radiotherapy can be followed by anomalies in the development and eruption of the dental buds. The severity of these secondary effects varies according to the patient’s age at the moment of the start of the specific therapy, the stage of dental development, the type of cytostatic medication and the dose and frequency of treatment cycles.

Keywords: , , ,
Full text: PDF

Complex Multitrauma Patient: Head, Thorax, Abdomen and Limbs

Gomotîrceanu F1, Ghiga Dana2, Petrişor M3, Haifa B3, Băţagă T1

1 County Emergency Clinical Hospital, Tîrgu Mureş, Romania
2 Department of Research Methodology, University of Medicine and Pharmacy, Tîrgu Mureş, Romania
3 Department of Medical Informatics and Biostatistics, University of Medicine and Pharmacy, Tîrgu Mureş, Romania

Introduction: Multiple trauma represents the main cause of death in 40–50 years old patients. It requires a rigorous management of the critical patient to ensure a correct order in the performed maneuvers and a maximum efficiency.
Case report: We report a case of a 27 year-old patient with multiple trauma, victim of a train accident. The patient arrives with the presumptive diagnosis of multiple trauma due to train accident, open acute craniocerebral trauma, suspicion of acute subdural hematoma. After the evaluation in the emergency service, the patient was transferred to the Tîrgu Mureş Surgery Clinic, where an emergency intervention was performed. Any of the lesions presented (abdomen, thorax, extremities and head lesions) were able to produce the patient’s death by themselves.
Conclusions: The survival chances of multiple trauma patients increase due to a rigorous management and the application of a standardized evaluation protocol.

Keywords: , ,
Full text: PDF

Livedoid and Gangrenous Dermatitis (Nicolau Syndrome)

Fekete GyL1, Fekete Júlia Edit2

1 Department of Dermatology, University of Medicine and Pharmacy, Tîrgu Mureş, Romania
2 Public Health Center, Tîrgu Mureş, Romania

Livedoid and gangrenous dermatitis is a rare posttherapeutic accident, produced by intravenous, intramuscular or intra-arterial drug injection under an oily or suspension form. It was first described by Stefan G. Nicolau in 1925 after injections of bismuth. The progression of the disease is favorable most cases are cured after 6–8 weeks. We present a clinical case of a patient aged 74 years.

Keywords: ,
Full text: PDF

Multifocal Sarcomatoid Carcinoma of the Small Intestine

Fülöp Emőke1, Marcu Simona Tünde1, Loghin Andrada1, Fülöp EF2, Mocan Simona3

1 Department of Histology, University of Medicine and Pharmacy, Tîrgu Mureş, Romania
2 Department of Internal Medicine, University of Medicine and Pharmacy, Tîrgu Mureş, Romania
3 Department of Pathology, County Emergency Clinical Hospital, Tîrgu Mureş, Romania

Sarcomatoid carcinomas (SCs) or carcinosarcomas are rare, biphasic tumors, with poor prognosis, only rarely located in the small and large intestine. The first treatment option of these tumors is surgical approach, adjuvant therapy showing no important role in the treatment protocol. We present the case of a 63 years old male patient, hospitalized in the Surgical Department II of the County Emergency Clinical Hospital Tîrgu Mureş with the diagnosis of small intestine tumor with jejunal localization. Microscopically, in hematoxylin-eosin (HE) staining, the tumor was consisting of two components, an epithelial and a mesenchymal one. From immunohistochemical point of view, tumor cells were strongly positive for cytokeratin AE1/AE3 as well as for vimentin. They were negative for epithelial membrane antigen (EMA), CD117, CD34, S100, chromogranin-A and synaptophisin. Based on the macroscopic and microscopic appearance, respectively the immunohistochemical feature of the tumor, the patient was diagnosed with multifocal sarcomatoid carcinoma of the small intestine.

Keywords: , ,
Full text: PDF

Particular Clinical-Therapeutic Aspects of Rhinophyma — Atypical Case Report

Andrei Liliana1, Bordeianu I2, Iordache IV2, Bratu I3

1 Hypocrate Medical Center, Tulcea, Romania
2 Faculty of Medicine, Ovidius University, Constanța, Romania
3 Faculty of Pharmacy, Ovidius University, Constanța, Romania

The authors present a case of pseudotumoral rhinophyma with some specific and rare clinical, evolutional and therapeutic aspects. Therapeutic indication was put on functional rather than cosmetic reasons, and surgery led to good functional and cosmetic results, accompanied by a fast spontaneous-directed epithelialization.

Keywords:
Full text: PDF

Alternative Therapeutic Strategy in Peripheral Arterial Disease of Lower Limbs

Popa Setalia1, Aursulesei Viviana2,5, Baroi Genoveva3,5, Ivanov Anca4,5, Miron Ingrith4,5, Datcu DM2,5

1 PhD student, “Grigore T. Popa” University of Medicine and Pharmacy, Iași, Romania
2 Department of Cardiology, Ist Internal Medicine Clinic, “Sf. Spiridon” Hospital, Iași, Romania
3 Vascular surgery Clinic, “Sf. Spiridon” Hospital, Iași, Romania
4 Haemato-Oncology Clinic, “Sf. Maria” Hospital, Iași, Romania
5 “Grigore T. Popa” University of Medicine and Pharmacy, Iași, Romania

Background: Treatment in peripheral artery disease consists mostly in symptoms management and measures to stop the progression of atherosclerosis. New therapeutic opportunities are opened by current research; they are based on angiogenesis induced by stem cell therapy and growth factor administration. Bone marrow is a rich tissue in cells and growth factors, and it was observed that in bone fracture hematoma, the angiogenesis is induced currently as a vascular response to injury.
Case report: A 42 year-old male patient with peripheral artery disease. The diagnosis was confirmed through angiography, and the surgeon confirmed the impossibility of revascularization. In consequence, the patient was proposed for vasodilatation treatment with prostaglandins. After one month with no improvement, the patient insisted to find a new possibility of treatment, thus we decided to use adult self stem cells from bone marrow. Sixty ml bone marrow aspirate was taken under local anesthesia from the iliac crest and injected intramuscular in the middle outer part of the thigh and gastrocnemian area in 38 injection sites. The patient was followed up for 6 months and we observed an improvement of clinical symptoms, walking perimeter and ankle brachial index.
Conclusion: This is the first case where we tried an innovative therapeutic strategy in a young patient with no other revascularization opportunity, with a benefic result.

Keywords: , ,
Full text: PDF

Atrophoderma Vermiculata – Case Report

Fekete GyL1, Fekete Júlia Edit2

1 Department of Dermatology, University of Medicine and Pharmacy, Tîrgu Mureş, Romania
2 Public Health Center, Tîrgu Mureş, Romania

Atrophoderma vermiculata is a rare genodermatosis probably inherited in an autosomal recessive pattern, characterized by follicular inflammation and atrophy. Together with keratosis pilaris atrophicans facies and keratosis follicularis spinulosa decalvans it belongs to a group of closely related conditions, characterized by keratosis pilaris and atrophy of the skin. Clinical manifestations with reticular atrophy of the skin in a honeycomb appearance are characteristic. The course is generally slow, with progressive worsening. We report a clinical case of a 59 year-old woman who presented a symmetric reticular atrophy of the face, which appeared when she was 18 years old, with progressive worsening in the last 3 years. The lesions were located on the forehead and cheeks, without any clinical symptoms. The disease is considered rare, the true incidence is unknown.

Keywords: , ,
Full text: PDF

Chondrodermatitis Nodularis Helicis

Fekete GyL1, Fekete Júlia Edit2

1 Department of Dermatology, University of Medicine and Pharmacy, Tîrgu Mureş, Romania
2 Public Health Center, Tîrgu Mureş, Romania

DOI: 10.2478/amma-2013-0013

Chondrodermatitis nodularis helicis is a rare and well defined clinical condition, characterized by the appearance of painful nodule or nodules located on the helix. Affects mainly white men, aged 50 and more. The pathogenesis of the disease is unclear. The used treatments gives excellent results, but the disease tends to relapse. We present a clinical case of a young man of 38 years of age with a painful nodule located on the left ear.

Keywords: , ,
Full text: PDF

Two Cases of Dorsal Urethral Duplication

Gozar H, Prișcă RA, Derzsi Z

Department of Pediatric Surgery and Orthopedics, County Emergency Clinical Hospital, Tîrgu Mureş, Romania

DOI: 10.2478/amma-2013-0012

Urethral duplication is a rare congenital anomaly. In addition to a normally urethra, there is an accessory urethra arising from the bladder or the proximal urethra which may open anywhere on the penis or even on the perineum. Many patients with this malformation are asymptomatic. Some patients may complain of intermittent discharge from the accessory urethra, incontinence, infection, double streams or stricture. The duplicated urethra may be complete or incomplete, may be located dorsal, ventral or in Y-type. The treatment of urethral duplication is individualized, depending on the type of malformation. We report two cases of dorsal urethral duplication discovered in two boys.

Keywords: , ,
Full text: PDF