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Recent Articles

2020-01-06 Case Report

A case study on Erdheim ‐ Chester Disease


In this brief essay, Harald Koeck offers an introduction to Professor Jakob Erdheim, an eminent pathologist of Vienna. Koeck is an independent researcher at different Pathology Departments (Department of Pathology St. Poelten with Prof. Hans Bank MD, Department of Pathology MSMC N.Y. with Prof. Alan L. Schiller MD, Department of Pathology Minsik with Prof. Jurij Bandaschewski MD and since 2008 at the Jakob Erdheim Institute Vienna Hospital Hietzing, Chair Univ. Prof. Walter Ulrich MD.

Abstract Read Full Article HTML DOI: 10.29328/journal.acr.1001027 Cite this Article

2020-02-06 Case Report

Delayed penile prosthesis implantation in the delayed presentation of ischemic priapism


Priapism is currently defined as a prolonged painful erection without sexual stimuli, if priapism persists > 36 hours, conservative treatment does not lead to detumescence.
The most common etiologies are: medications into corpora cavernosa, anti-psychotics, anti-hypertensives, hematological disorders (chronic myeloid leukemia).

The Penile prosthesis is the choice treatment for restoring the erectile function after the failure of the conservative treatment.

But the corporal fibrosis makes it very difficult, with high risk of complications [1].

Abstract Read Full Article HTML DOI: 10.29328/journal.acr.1001028 Cite this Article

2020-02-26 Case Report

Acrometastasis as first sign of adenocarcinoma of the lung


Lung cancer is a major cause of morbidity and mortality worldwide. Metastasis can be seen in many organs in advanced-stage disease. Acral metastasis rate in cancer is quite low. However, because of the direct opening of the arterial circulation, the risk of acral metastasis stem from lung cancer is higher than any other cancers. Although the mechanism is not known exactly, acral metastases occur in dominant extremities. Here, we present a case with lung adenocarcinoma metastasis of the left hand in the second phalanx. We presented this case which is rarely seen in the literature to emphasize acral metastases.

Abstract Read Full Article HTML DOI: 10.29328/journal.acr.1001029 Cite this Article

2020-03-04 Case Report

Zoon’s Vulvitis: A case report


Zoon’s vulvitis or plasma cell vulvitis (PCV) is a rare, benign inflammatory condition of the vulvar mucosa [1].  PCV can present with an asymptomatic lesion, or can cause discomfort, dyspareunia and pruritus [2]. In this way, PCV can mimic other lesions of the vulval mucosa, such as lichen planus.

Abstract Read Full Article HTML DOI: 10.29328/journal.acr.1001030 Cite this Article

2020-03-16 Case Report

Giant prolactinoma case with side effects due to cabergoline


Dopamine agonists should usually be the first treatment for patients with prolactinomas of all sizes, because these drugs decrease serum prolactin concentrations and decrease the size of most lactotroph adenomas. Cabergoline is preferred first. When cabergoline develops side effects bromokriptin is switched. Cabergoline is more efficient than bromocriptine. Its side effect profile more favorable than bromocriptine. Cabergoline is an ergot dopamine agonist that is administered once or twice a week. Cabergoline can have rarely serious psychiatric adverse effects, including psychosis, impulse control disorders, dyskinesia, pulmonery fibrosis and valvular heart disease.
Prolactinomas are the most common pituitary tumors, 93%-95% of the cases are microadenomas. Macroprolactinomas larger than 40 mm, known as giant prolactinomas, are exceptionally rare, accounting for 0.5%–4% of all prolactin-hypersecreting adenomas.

In our case, after the 7 x 6 cm giant macroprolactinoma operated we report the manic episode occuring during the second week of cabergoline treatment. In the treatment of patients with prolactinoma, cabergoline is a first choice drug because it has a better tolerance profile and is more effective, however, bromocriptine can be switched to when drug resistance or side effects develop to cabergoline.


Abstract Read Full Article HTML DOI: 10.29328/journal.acr.1001031 Cite this Article

2020-03-18 Case Report

Epstein-Barr infection causing toxic epidermal necrolysis, hemophagocytic lymphohistiocytosis and cerebritis in a pediatric patient


Toxic epidermal necrolysis -the most serious variant of Steven Johnson Syndrome -arises as the result of cell-mediated cytotoxic reaction against keratinocytes. Most common inciting factors include drugs, and infections. On the other hand, Hemophagocytic lymphohistiocytosis (HLH), is a syndrome characterized by enormous immune response in the absence of down-regulation of activated immune cells resulting in cytokine storm causing severe tissue damage.

Up to date, several cases of concomitance of Toxic Epidermal Necrolysis (TEN) and Hemophagocytic Lympohystiocytosis (HLH) in pediatric patients have been reported. Both situations can be fatal and pediatricians should be aware that these two clinical entities are not mutually exclusive, to the contrary they may coexist.

We herein describe a case of Toxic Epidermal Necrolysis, complicated with Hemophagocytic Lymphohistiocytosis with Central Nervous System involvement due to EBV infection.

Abstract Read Full Article HTML DOI: 10.29328/journal.acr.1001032 Cite this Article