RESUMEN
Carcinoma of the gallbladder is an uncommon malignancy with a poor prognosis overall. Histologically, adenocarcinoma is the most common type of gallbladder carcinoma. Adenosquamous carcinoma is a rare histological type of gallbladder carcinoma comprising both the glandular and squamous elements. Adenosquamous carcinoma shows more aggressive behavior than adenocarcinomas and is often detected in a late advanced stage. Treatment is usually extended surgical resection but has a poor prognosis. We present a rare case of adenosquamous carcinoma with lymphovascular invasion in a 72-year-old male who was managed with extended cholecystectomy.
RESUMEN
Multiple ring-enhancing lesions are commonly encountered abnormalities in neuroimaging. There are many differentials for such lesions as infections, neoplasms, vascular lesions, inflammatory and demyelinating conditions, and granulomatous diseases. In developing countries, tuberculoma and neurocysticercosis are the two important etiologies to be considered. This case report illustrates how multiple ring-enhancing lesions can lead to our management in one direction while the true diagnosis remains elusive. A 53-year-old male who presented with a headache was initially diagnosed and treated as neurocysticercosis, then neurosarcoidosis ultimately turned out to be a case of Central Nervous System Tuberculosis on further evaluation. Consideration of only clinical scenarios and neurological imaging can lead to diagnostic inaccuracy, mismanagement and poor outcome, therefore, other supporting lab investigations should be considered for making a correct diagnosis. Keywords: brain; case reports; neurocysticercosis; sarcoidosis; tuberculoma.
Asunto(s)
Enfermedades del Sistema Nervioso Central , Neurocisticercosis , Sarcoidosis , Tuberculoma , Tuberculosis del Sistema Nervioso Central , Masculino , Humanos , Persona de Mediana Edad , Neurocisticercosis/complicaciones , Neurocisticercosis/diagnóstico , Neurocisticercosis/patología , Enfermedades del Sistema Nervioso Central/complicaciones , Enfermedades del Sistema Nervioso Central/diagnóstico , Sarcoidosis/complicaciones , Sarcoidosis/diagnóstico , Tuberculosis del Sistema Nervioso Central/complicaciones , Tuberculosis del Sistema Nervioso Central/diagnóstico , Imagen por Resonancia MagnéticaRESUMEN
Iodine deficiency is a major cause of thyroid disorders worldwide. Nepal lies in the endemic area of iodine deficiency which was previously referred to as Himalayan goiter belt, with high prevalence of iodine deficiency disorders including goiter, cretinism and hypothyroidism. With effective implementation of universal salt iodization program, Nepal has a successful public health story to share having drastically reduced the iodine deficiency disorders. Moreover, challenge has appeared with rising number of excess iodine states. Thyroid dysfunction is growing higher and the increasing proportion of hyperthyroidism is particularly concerning. Time has come for us to suitably review the standards of salt iodization and control the increasing number of cases with thyroid dysfunction by the coordinated efforts of all stakeholders, along with sustaining the optimal level of iodine.