Pilar cysts are common benign cysts of follicular origin that typically arise in areas of skin containing dense hair follicles such as the scalp. Here we describe a unique case of a young woman who was found to have a pilar cyst on the dorsum of her hand, a rather atypical location given the relative lack of pilosebaceous units. This case illustrates the variability in pilar cyst presentation and the importance of considering a pilar cyst in the differential diagnosis of a patient presenting with a tumor of the dorsal hand.

We present successful surgical treatment of a patient with chronic kidney disease (CKD) and hyperparathyroidism undergoing renal replacement therapy. At baseline, parathyroidectomy via cervical access was performed for parathyroid adenomas. After 6 years, clinical and laboratory relapse of disease required thoracoscopic resection of atypically located anterior mediastinal adenoma. This case demonstrates that this disease is one of the most difficult in modern medicine requiring a special approach in diagnosis and treatment. Patients with CKD and hyperparathyroidism need for follow-up, control of total and ionized serum calcium, inorganic phosphorus and parathormone, osteodensitometry, ultrasound and scintigraphy of thyroid and parathyroid glands, and, if necessary, CT or MRI of the neck and chest organs.
Представлен случай успешного хирургического лечения пациентки с хронической болезнью почек (ХБП) и гиперпаратиреозом, находящейся на заместительной почечной терапии методом программного гемодиализа, — удаления аденом околощитовидных желез (ОЩЖ) сначала путем тотальной паратиреоидэктомии из шейного доступа, а затем, через 6 лет, при возникновении клинико-лабораторного рецидива заболевания, путем торакоскопического удаления атипично расположенной аденомы переднего средостения. Представленное наблюдение служит доказательством того, что это заболевание является одним из самых непростых в современной медицине и требует особого подхода в диагностике и лечении. Пациенты с ХБП и гиперпаратиреозом нуждаются в постоянном динамическом наблюдении: контроле уровня общего и ионизированного кальция, неорганического фосфора и паратгормона в сыворотке крови, периодическом выполнении денситометрии скелета, ультразвукового исследования, сцинтиграфии щитовидной железы и околощитовидных желез и при необходимости компьютерной томографии или магнитно-резонансной томографии органов шеи и грудной клетки.

Lymphoplasmocytic plaque in children (LPC) is a rare and distinctive skin disorder primarily affecting the pediatric population. Characterized by its unique histopathological features, the condition manifests as well-defined plaques with a predominance of lymphocytes and plasma cells infiltrating the dermis. Despite its limited prevalence, recognizing this entity is crucial for accurate diagnosis and appropriate management of affected patients. We report the case of a 10-year-old male presenting with LPC in the extensor surface of the upper arm, a rarely reported location, treated with both topical and intralesional corticosteroids resulting in partial improvement.

BACKGROUND: Zollinger-Ellison syndrome (ZES) results from hypersecretion of gastrin from pancreatic or duodenal neuroendocrine tumors, commonly referred to as gastrinomas. The high levels of gastrin lead to a typical presentation involving watery diarrhea and multiple ulcers in the duodenum. Here, we have presented the rare case of a patient with ZES and absence of hypergastrinemia as well as an atypical location of gastrinoma.
METHODS: A 72-year-old woman presented with the typical clinical manifestations of ZES, including upper abdominal pain, significant watery diarrhea, and acidic liquid vomitus. Surprisingly, however, she did not have an increased level of serum gastrin. In addition, there was no evidence of gastrinoma or any other ulcerogenic tumor. Esophagogastroduodenoscopy was conducted to examine the upper digestive tract. Revised diagnoses were considered, and an individualized treatment plan was developed. The patient responded to antacid medication while experiencing intermittent, recurring bouts of ZES. 18F-AlF-NOTA-octreotide positron emission tomography (18F-OC PET)/computed tomography (CT) helped locate the tumor. Postoperative pathology and immunohistochemistry results suggested that the tumor was a gastrinoma located at an unconventional site.
CONCLUSIONS: This present case study demonstrates the possibility of ZES-like manifestation in patients with absence of hypergastrinemia. 18F-OC PET/CT is a relatively new imaging technique that can be applied for diagnosing even tiny gastrinomas that are atypical in terms of location.

A 55-year-old female presented with elastofibroma of the thigh. On presentation, she complained of a palpable, painful mass on the anterolateral right thigh that had been present for one year. She had a history of surgery for a right femur fracture. On MRI, a soft-tissue mass was seen in the vastus intermedius muscle, as a heterogeneous lesion with streaky fatty and fibrous components. The fibrous component was isointense to the muscle, and the fatty component had a high signal on both T1- and T2-weighted images. Histopathological analysis after biopsy established the diagnosis of elastofibroma.

Hidradenitis suppurativa (HS) is a chronic inflammatory disorder that is characterized by deep-seated painful nodules, classically in the intertriginous skin and apocrine gland-rich areas of the body such as the anogenital, axillary, inframammary and inguinal regions. This is a case of a 35-year-old female, who is known to have gluteal HS, she underwent neck liposuction procedure that was then complicated by anterior neck HS, which is considered as an atypical location. The patient received medical treatment with antibiotics and showed huge improvement. In addition, in patients who do not show response to medical therapy, surgical treatment is usually carried out by incising the area affected and leaving the wound open to be healed by secondary intention or covering it with a skin graft if the area is extensive.

UNASSIGNED: Squamous cell carcinoma occurring in the rectum is a very rare malignancy. When encountered in the gastrointestinal tract, it usually involves the esophagus or the anal canal. The rare incidence of rectal squamous cell carcinomas has raised quite a few questions on the hypothetical etiologies and prognosis.
METHODS: In this report, we present a case of a 73 years old woman who presented a rare case of squamous cell carcinoma, at 8 cm from the anal margin.
UNASSIGNED: Optimal treatment sequence of such an uncommon disease is yet to be standardized, surgery was the gold standard management for rectal squamous cell carcinoma, but exclusive chemoradiotherapy is slowly but surely supplanting it.
CONCLUSIONS: This case allows us to engage in discussions over the uncommon location of the rectal SCC and its current treatment management. The exclusive chemoradiation therapy has given excellent results becoming the gold standard treatment of this rare entity.

暂无摘要。

Pigmented villonodular synovitis (PVNS) is an idiopathic villous overgrowth and pigmentation of the synovial membrane of a single joint. It is an uncommon condition characterized by yellow or yellowish-brown colour due to deposits of cholesterol and hemosiderin, excessive secretion of yellowish-brown synovial fluid, and the formation of brownish chocolate synovial tissue. This condition commonly occurs at the knee joint at the age of 20-50 years. Here we present a case of a 75-year-old male with PVNS involving the lower third of the right thigh who came to the surgery department and was eventually referred to the orthopedic department on the basis of investigations performed. It is a case of PVNS at a unique location on the lower third of the right thigh. The swelling was painless initially, but the pain increased over a duration of 10 months. Clinically, the mass was suspected to be bursitis or lipoma with features of mild inflammation in the overlying skin. Magnetic resonance imaging (MRI) suggested a swelling of 100*70*40 mm in dimension with the possibility of PVNS. Ultrasonography (USG) of the mass and fine needle aspiration cytology (FNAC) supported the diagnosis of PVNS. An excisional biopsy of the swelling was submitted. Per-operatively, there were typical features of PVNS. The swelling was situated superficial to the iliotibial band. There was no defect or gap in the iliotibial tract, and the swelling didn\'t have any continuity to the knee joint. The occurrence of synovial tissue without any attachment to the joint or tendon is rare and hence reported.

Henoch-Schönlein purpura (HSP) is a self-limited systemic vasculitis seen most commonly in paediatric group with multi organ involvements. We report a case of an infantile female who presented with cough, diarrhoea and vomiting. Two days later, she suddenly developed an erythematous, non-pruritic rash involving feet, thighs, buttocks and face; the lesion spared the trunk. Joints pain and swellings were also noticed. Coronavirus disease-19 Polymerase chain reaction (PCR) test was negative. She was diagnosed with HSP based on the American College of Rheumatology and European League Against Rheumatism, and Paediatric Rheumatology European Society criteria. The rash faded spontaneously within 2 weeks. We conclude that the careful skin examination is crucial for diagnosis of HSP.