RESUMEN
Gastric and intestinal mucosal hyperplasia and polyps are identified as a cause of morbidity and mortality in moray eels. This report describes the clinical presentations, diagnostic procedures, and therapeutic interventions in eight moray eels diagnosed with gastric polypoid hyperplasia. All described cases were humanely euthanized or found deceased, and multifocal adenomatous hyperplasia and polyps extending from the gastric mucosal epithelium were identified in all cases. The moray eels diagnosed with adenomatous hyperplasia and polyps often exhibited anorexia, regurgitation, and occasional changes in buoyancy, and supportive care was unsuccessful in alleviating or resolving these signs.
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Anguilas , Hiperplasia , Animales , Hiperplasia/veterinaria , Hiperplasia/patología , Femenino , Masculino , Enfermedades de los Peces/patología , Enfermedades de los Peces/diagnóstico , Pólipos/veterinaria , Pólipos/patología , Pólipos/diagnóstico , Gastropatías/veterinaria , Gastropatías/patología , Gastropatías/diagnósticoRESUMEN
Gastric polyps (GPs) are increasingly common. On upper endoscopy, they should be examined with white light and occasionally chromoendoscopy, and their morphology classified according to the Paris classification. Most GPs have a typical endoscopic appearance and can be associated with diseases like Helicobacter pylori infection. Histological examination is necessary for an accurate diagnosis. While most polyps are non-neoplastic and do not require treatment, some carry a risk of malignancy or are already malignant. Therefore, understanding the diagnosis, classification, and management of GPs is crucial for patient prognostication. Our new classification categorizes GPs into "good", "bad", and "ugly" based on their likelihood of becoming malignant. We aim to provide descriptions of the endoscopic appearance, pathology, treatment, and follow-up for different GPs, as well as clinical management flowcharts.
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Infecciones por Helicobacter , Neoplasias Gástricas , Humanos , Neoplasias Gástricas/clasificación , Neoplasias Gástricas/patología , Infecciones por Helicobacter/diagnóstico , Infecciones por Helicobacter/microbiología , Infecciones por Helicobacter/patología , Infecciones por Helicobacter/complicaciones , Gastroscopía , Helicobacter pylori/aislamiento & purificación , Pronóstico , Pólipos/clasificación , Pólipos/patología , Pólipos/diagnóstico , Pólipos Adenomatosos/patología , Pólipos Adenomatosos/clasificaciónRESUMEN
BACKGROUND: Polypoidal choroidal vasculopathy (PCV) is a hemorrhagic fundus disease that can lead to permanent vision loss. Predicting the treatment response to anti-VEGF monotherapy in PCV is consistently challenging. We aimed to conduct a prospective multicenter study to explore and identify the imaging biomarkers for predicting the anti-VEGF treatment response in PCV patients, establish predictive model, and undergo multicenter validation. METHODS: This prospective multicenter study utilized clinical characteristics and images of treatment naïve PCV patients from 15 ophthalmic centers nationwide to screen biomarkers, develop model, and validate its performance. Patients from Peking Union Medical College Hospital were randomly divided into a training set and an internal validation set. A nomogram was established by univariate, LASSO regression, and multivariate regression analysis. Patients from the other 14 centers served as an external test set. Area under the curve (AUC), sensitivity, specificity, and accuracy were calculated. Decision curve analysis (DCA) and clinical impact curve (CIC) were utilized to evaluate the practical utility in clinical decision-making. FINDINGS: The eye distribution for the training set, internal validation set, and external test set were 66, 31, and 71, respectively. The 'Good responder' exhibited a thinner subfoveal choroidal thickness (SFCT) (230.67 ± 61.96 vs. 314.42 ± 88.00 µm, p < 0.001), lower choroidal vascularity index (CVI) (0.31 ± 0.08 vs. 0.36 ± 0.05, p = 0.006), fewer choroidal vascular hyperpermeability (CVH) (31.0 vs. 62.2%, p = 0.012), and more intraretinal fluid (IRF) (58.6 vs. 29.7%, p = 0.018). SFCT (OR 0.990; 95% CI 0.981-0.999; p = 0.033) and CVI (OR 0.844; 95% CI 0.732-0.971; p = 0.018) were ultimately included as the optimal predictive biomarkers and presented in the form of a nomogram. The model demonstrated AUC of 0.837 (95% CI 0.738-0.936), 0.891 (95% CI 0.765-1.000), and 0.901 (95% CI 0.824-0.978) for predicting 'Good responder' in the training set, internal validation set, and external test set, respectively, with excellent sensitivity, specificity, and practical utility. INTERPRETATION: Thinner SFCT and lower CVI can serve as imaging biomarkers for predicting good treatment response to anti-VEGF monotherapy in PCV patients. The nomogram based on these biomarkers exhibited satisfactory performances.
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Inhibidores de la Angiogénesis , Biomarcadores , Tomografía de Coherencia Óptica , Factor A de Crecimiento Endotelial Vascular , Humanos , Masculino , Femenino , Estudios Prospectivos , Anciano , Persona de Mediana Edad , Inhibidores de la Angiogénesis/uso terapéutico , Inhibidores de la Angiogénesis/administración & dosificación , Factor A de Crecimiento Endotelial Vascular/antagonistas & inhibidores , Coroides/irrigación sanguínea , Coroides/diagnóstico por imagen , Neovascularización Coroidal/tratamiento farmacológico , Neovascularización Coroidal/diagnóstico por imagen , Resultado del Tratamiento , Nomogramas , Pólipos/tratamiento farmacológico , Pólipos/diagnóstico por imagen , Pólipos/diagnóstico , Angiografía con Fluoresceína/métodos , Enfermedades de la Coroides/tratamiento farmacológico , Enfermedades de la Coroides/diagnóstico por imagen , Enfermedades de la Coroides/diagnóstico , Vasculopatía Coroidea PolipoideaRESUMEN
BACKGROUND: Gallbladder polyps are increasingly being identified due to the widespread use of abdominal ultrasound imaging. They are concerning lesions due to their potential malignant risk. It is hoped that managing them correctly will play a role in improving poor survival rates of gallbladder cancer. Awareness of these lesions is lacking. Management continues to be guided by expert opinion and observational studies and a number of consensus statements exist. OBJECTIVE: This paper reviews and summarises the current literature and provides an approach for general practitioners based on the available guidance. DISCUSSION: Although minor variation exists between consensus statements, the risk of malignancy for gallbladder polyps is still largely dictated by size, with those ≤5 mm generally considered to pose little risk and not requiring follow-up, whereas those ≥10 mm considered at greater risk and requiring referral for cholecystectomy.
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Neoplasias de la Vesícula Biliar , Pólipos , Humanos , Pólipos/diagnóstico , Neoplasias de la Vesícula Biliar/terapia , Ultrasonografía/métodos , Médicos Generales , Enfermedades de la Vesícula Biliar/terapiaRESUMEN
Menetrier's disease represents a low prevalence clinical entity, characterized by complexity in its diagnosis, particularly due to the need to exclude its potential association with gastric cancer. In this context, we present the clinical case of a 54-year-old male with nonspecific gastrointestinal symptoms and hypoalbuminemia. During the upper endoscopy procedure, a noticeable thickening of gastric folds was observed, associated with multiple polypoid lesions in the stomach, predominantly in the fundus and body. Since the patient did not show improvement in symptoms and given the inability to rule out gastric cancer, total gastrectomy was chosen as the treatment. Surgical specimen and histology confirmed the presence of Menetrier's disease.
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Gastritis Hipertrófica , Pólipos , Humanos , Masculino , Persona de Mediana Edad , Gastritis Hipertrófica/complicaciones , Gastritis Hipertrófica/diagnóstico , Pólipos/diagnóstico , Pólipos/complicaciones , Pólipos/cirugía , Pólipos/patología , Gastropatías/diagnóstico , Gastropatías/complicaciones , Hiperplasia , Gastrectomía , Neoplasias Gástricas/diagnóstico , Neoplasias Gástricas/patología , Neoplasias Gástricas/complicaciones , Neoplasias Gástricas/cirugía , Pólipos AdenomatososRESUMEN
OBJECTIVE(S): The objective of this study is to compare treatment outcomes for vocal fold polyps (VFPs) between operating room microlaryngoscopy and office-based photoangiolysis with the potassium titanyl phosphate (KTP) laser. METHODS: Prospective nonrandomized cohort study of patients with VFPs undergoing microlaryngoscopy ("OR group") or KTP laser photoangiolysis ("KTP group"). Voice outcomes (patient-reported outcome measures [Voice Handicap Index-10 (VHI-10) and Singing VHI-10 (SVHI-10)], auditory-perceptual measures [Consensus Auditory-Perceptual Evaluation of Voice (CAPE-V)], videostroboscopic characteristics [Voice-Vibratory Assessment of Laryngeal Imaging (VALI)], and acoustic and aerodynamic measures) were performed at baseline and regular intervals after intervention. RESULTS: Forty-four subjects (17 OR group, 27 KTP group) with VFPs were enrolled. Mean VHI-10 significantly improved from baseline to each follow-up interval in both groups, except for the 1-2-week interval in the OR group. Mean SVHI-10 improved for both groups at some intervals. Growth curve models and time-to-event analyses for patient-reported outcomes did not differ between groups. There were significant improvements in all categories of auditory-perceptual voice quality and some categories of videostroboscopic characteristics in both groups. No significant trends were identified in acoustic and aerodynamic measures. Improvements in most outcomes did not significantly differ between groups or based on polyp size. There were no major complications. CONCLUSIONS: Significant improvements in patient-reported voice outcomes measures, auditory-perceptual voice evaluation, and videostroboscopic characteristics occur following surgical treatment of vocal fold polyps with either microlaryngoscopy or office-based KTP laser. Long-term voice outcomes do not significantly differ between treatment modalities. LEVEL OF EVIDENCE: 3 Laryngoscope, 134:S1-S20, 2024.
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Enfermedades de la Laringe , Laringoscopía , Láseres de Estado Sólido , Pólipos , Pliegues Vocales , Humanos , Estudios Prospectivos , Pólipos/cirugía , Pólipos/diagnóstico , Femenino , Masculino , Pliegues Vocales/cirugía , Pliegues Vocales/fisiopatología , Persona de Mediana Edad , Laringoscopía/métodos , Resultado del Tratamiento , Enfermedades de la Laringe/cirugía , Enfermedades de la Laringe/diagnóstico , Adulto , Láseres de Estado Sólido/uso terapéutico , Calidad de la Voz , Terapia por Láser/métodos , Anciano , Medición de Resultados Informados por el Paciente , Microcirugia/métodosRESUMEN
OBJECTIVE: To compare the detection rate and diagnostic accuracy of cardia polyps using endoscopy with blue laser imaging (BLI) and white-light imaging (WLI). METHODS: Patients were randomly divided into the BLI group and WLI group according to the endoscopic procedures. BLI followed by WLI was conducted in the BLI group, whereas WLI followed by BLI examination was conducted in the WLI group. The number, size, microstructure, and microvascular patterns of cardia polyps detected were recorded. Biopsy of the polyps was then performed. RESULTS: The detection rate of cardia polyps in the BLI group was higher than that in the WLI group (7.87% vs 4.22%, P = 0.018). The rate of overlooked lesions in the BLI group was lower than in the WLI group (0.64% vs 3.38%, P = 0.003). The diagnostic coincidence rate between magnifying BLI and histopathology was 88.16%. The sensitivity, specificity, positive predictive value and negative predictive value for the diagnosis of neoplastic lesions by magnifying endoscopy with BLI were 90.91%, 87.69%, 55.56%, and 98.28%, respectively. The most remarkable patterns for predicting inflammatory polyps were the prolonged and fine network patterns (sensitivity 71.43%, specificity 93.75%). Small round combined with honeycomb patterns were the most common among fundic gland polyps (sensitivity 80.00%, specificity 98.48%). Neoplastic lesions presented as villous or ridge-like combined with core vascular or unclear pattern for both microvascular and microstructure patterns. CONCLUSION: BLI is more effective than WLI in the detection and diagnosis of cardia polyps, and magnifying endoscopy with BLI may help diagnose such lesions.
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Cardias , Estudios de Factibilidad , Neoplasias Gástricas , Humanos , Femenino , Masculino , Persona de Mediana Edad , Cardias/patología , Cardias/diagnóstico por imagen , Adulto , Neoplasias Gástricas/diagnóstico por imagen , Neoplasias Gástricas/diagnóstico , Neoplasias Gástricas/patología , Anciano , Pólipos/diagnóstico por imagen , Pólipos/diagnóstico , Gastroscopía/métodos , Sensibilidad y Especificidad , Valor Predictivo de las Pruebas , Rayos LáserRESUMEN
PURPOSE: To investigate the association between the arm-to-choroidal circulation time (ACT) on indocyanine green angiography (IA) and clinical profile in patients with polypoidal choroidal vasculopathy (PCV). STUDY DESIGN: Single-center retrospective study. METHODS: We included 38 eyes of 38 patients with PCV diagnosed using multimodal imaging and did not undergo previous treatment. All patients were treated with monthly aflibercept injections for 3 months and treat-and-extend regimens for the subsequent 12 months. Posterior vortex vein ACT was assessed on the first visit using Heidelberg IA. The patients were divided into two groups: ACT ≥20 s (L group; eight eyes) and ACT <20 s (S group; 30 eyes). The clinical profiles before and after treatment were analyzed to assess associations with ACT. RESULTS: The mean ACT was 16.39±3.3 s (L group: 21.25±1.49 s, women:men=2:6, mean age: 77.3±6.5 years; S group: 15.10±2.17 s, women:men=7:23, mean age: 75.5±6.9 years). No significant difference was observed in the mean subfoveal choroidal thickness between the L and the S groups (176±75 µm vs. 230±79 µm, P=0.10). However, there were significant differences between the L and S groups in retinal fluid accumulation and hemorrhage recurrence (eight/eight eyes, 100% vs. 13/30 eyes, 43%, P<0.001), mean aflibercept injections (8.8±1.6 vs. 7.0±1.6, P<0.01) during the 12-month period, and the number of polypoidal lesions (1.8±0.7 vs. 1.3±0.5, P<0.05). CONCLUSION: Patients with PCV and ACT >20 s are more likely to experience exudative change recurrence in the retina during treatment because they have more polypoidal lesions.
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Coroides , Fondo de Ojo , Vasculopatía Coroidea Polipoidea , Pólipos , Receptores de Factores de Crecimiento Endotelial Vascular , Anciano , Anciano de 80 o más Años , Femenino , Humanos , Masculino , Inhibidores de la Angiogénesis/administración & dosificación , Inhibidores de la Angiogénesis/uso terapéutico , Velocidad del Flujo Sanguíneo/fisiología , Coroides/irrigación sanguínea , Coroides/diagnóstico por imagen , Colorantes/administración & dosificación , Angiografía con Fluoresceína/métodos , Estudios de Seguimiento , Verde de Indocianina/administración & dosificación , Inyecciones Intravítreas , Imagen Multimodal , Vasculopatía Coroidea Polipoidea/diagnóstico , Vasculopatía Coroidea Polipoidea/tratamiento farmacológico , Pólipos/diagnóstico , Pólipos/tratamiento farmacológico , Pólipos/fisiopatología , Receptores de Factores de Crecimiento Endotelial Vascular/uso terapéutico , Receptores de Factores de Crecimiento Endotelial Vascular/administración & dosificación , Proteínas Recombinantes de Fusión/administración & dosificación , Proteínas Recombinantes de Fusión/uso terapéutico , Flujo Sanguíneo Regional/fisiología , Estudios Retrospectivos , Tomografía de Coherencia Óptica/métodos , Agudeza VisualRESUMEN
BACKGROUND/AIM: The long-term use of proton pump inhibitors (PPIs) has been reported to be strongly associated with the development of fundic gland polyps (FGPs). Conversely, a few cases of gastric hyperplastic polyps (GHPs) associated with PPI use have been reported. We experienced a case of PPI-associated multiple GHPs with uncontrollable bleeding. CASE REPORT: A 64 year old man with a history of rheumatoid arthritis presented to the hospital with complaints of vertigo and black stools. Blood tests revealed anemia and hypoproteinemia. Esophagogastroduodenoscopy (EGD) showed blood and black residue accumulated in the stomach. The source of the bleeding was multiple hyperplastic polyps. Bleeding could be stopped even with fasting, and total blood transfusions amounted to 28 units of RBCs were required in 18 days. After the cessation of PPI, EGD showed that the polyps had almost disappeared. Pathological diagnosis of resected polyp was hyperplastic polyp, which was characterized by capillary hyperplasia and edema. Gastrin receptors were over-expressed in the foveolar epithelium and not in the capillaries. Methotrexate (MTX)-induced portal hypertensive gastroenteropathy was revealed during follow-up. We consider that the effect of portal hypertension may have caused the capillary hyperplasia. CONCLUSION: Although PPI-related polyps are usually fundic gland polyps and do not cause life-threatening adverse events, we experienced PPI-related GHPs in which hemostasis was difficult to control.
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Pólipos Adenomatosos , Inhibidores de la Bomba de Protones , Humanos , Masculino , Inhibidores de la Bomba de Protones/efectos adversos , Persona de Mediana Edad , Hiperplasia , Hemorragia Gastrointestinal/etiología , Hemorragia Gastrointestinal/inducido químicamente , Hemorragia Gastrointestinal/diagnóstico , Neoplasias Gástricas/complicaciones , Neoplasias Gástricas/tratamiento farmacológico , Neoplasias Gástricas/patología , Neoplasias Gástricas/diagnóstico , Pólipos/patología , Pólipos/diagnóstico , Pólipos/inducido químicamente , Endoscopía del Sistema DigestivoRESUMEN
Bronchial fibroepithelial polyps are exceedingly rare with few cases have been reported. They can manifest with a wide array of symptoms; ranging from being totally asymptomatic, cough, refractory dyspnea, and hemoptysis. In our case, our patient's condition was diagnosed and was managed as asthma. It is one of the rare benign conditions to be encountered, shares similar morphology with other tumors such as angiomyofibroblastoma, aggressive angiomyxoma, and cellular angiofibroma. These lesions have a slow growth pattern which may end up with obstruction. According to the tumor size and symptoms caused by it, treatment varies from observation to complete resection. This case describes an incidental finding of fibroepithelial polyp in the main bronchus for a patient with long-term refractory cough for 5 years, was misdiagnosed to have asthma. Diagnosis typically involves imaging and bronchoscopy, followed by appropriate therapeutic measures and careful monitoring to assess the prognosis.
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Asma , Neoplasias de los Bronquios , Broncoscopía , Errores Diagnósticos , Pólipos , Humanos , Asma/diagnóstico , Pólipos/patología , Pólipos/diagnóstico , Neoplasias de los Bronquios/diagnóstico , Neoplasias de los Bronquios/patología , Neoplasias de los Bronquios/diagnóstico por imagen , Neoplasias de los Bronquios/cirugía , Masculino , Tomografía Computarizada por Rayos X , Persona de Mediana Edad , Tos/etiología , Femenino , Neoplasias Fibroepiteliales/patología , Neoplasias Fibroepiteliales/diagnóstico , Neoplasias Fibroepiteliales/cirugía , Bronquios/patologíaRESUMEN
PURPOSE: To evaluate the efficacy of intravitreal brolucizumab in polyp regression of treatment-naive polypoidal choroidal vasculopathy (PCV) patients and its effect on 1-year treatment outcome. METHODS: Medical records of 31 treatment-naive PCV patients, who received three monthly intravitreal brolucizumab injections followed by as-needed injections for at least a year, were retrospectively reviewed. Visual and anatomical outcomes were evaluated at 3, 6, and 12 months. Complete polyp regression rate and percentage change of vascular lesion and polyp area were evaluated after three monthly injections of brolucizumab. The effect of complete polyp regression and the impact of vascular lesion and polyp reduction rate on 1-year treatment outcome were also evaluated. RESULTS: In terms of visual outcome, best-corrected visual acuity significantly improved after 12-month follow-up (p < 0.001). In terms of anatomical outcome, central macular thickness (CMT) and central choroidal thickness significantly decreased after 12-month follow-up (p < 0.001). Complete polyp regression was observed in 23 patients (74.2%) after three monthly injections. Group with complete polyp regression had a higher rate of achieving dry macula at 3 months (p = 0.026) and fewer number of injections (p < 0.001) compared to the group without complete polyp regression. Higher polyp reduction rate was significantly associated with higher CMT change from baseline at 3 months (p = 0.048) while higher vascular lesion reduction rate was significantly associated with higher CMT change from baseline at 12 months (p = 0.031) and fewer number of injections (p = 0.012). CONCLUSIONS: Intravitreal brolucizumab injection effectively improved visual and anatomical outcomes and achieved significant polyp regression in treatment-naive PCV patients. Complete polyp regression and the reduction rate of vascular lesion size and polyp size after loading injection significantly influence the treatment outcome of PCV patients. However, careful monitoring and preoperative warning is warranted due to occurrence of brolucizumab-related IOI.
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Inhibidores de la Angiogénesis , Anticuerpos Monoclonales Humanizados , Coroides , Angiografía con Fluoresceína , Inyecciones Intravítreas , Pólipos , Tomografía de Coherencia Óptica , Agudeza Visual , Humanos , Masculino , Femenino , Estudios Retrospectivos , Pólipos/tratamiento farmacológico , Pólipos/diagnóstico , Angiografía con Fluoresceína/métodos , Inhibidores de la Angiogénesis/administración & dosificación , Anciano , Tomografía de Coherencia Óptica/métodos , Coroides/irrigación sanguínea , Coroides/patología , Resultado del Tratamiento , Estudios de Seguimiento , Anticuerpos Monoclonales Humanizados/administración & dosificación , Anticuerpos Monoclonales Humanizados/uso terapéutico , Persona de Mediana Edad , Fondo de Ojo , Neovascularización Coroidal/tratamiento farmacológico , Neovascularización Coroidal/diagnóstico , Neovascularización Coroidal/fisiopatología , Factores de Tiempo , Enfermedades de la Coroides/tratamiento farmacológico , Enfermedades de la Coroides/diagnóstico , Factor A de Crecimiento Endotelial Vascular/antagonistas & inhibidores , Vasculopatía Coroidea PolipoideaRESUMEN
INTRODUCTION: Electrocautery with a snare probe offers a tool for the treatment of endobronchial polyps. The aim of this study was to demonstrate the efficacy of the snare probe in patients undergoing rigid bronchoscopy due to central airway obstruction. METHODS: This retrospective descriptive study included patients who underwent rigid bronchoscopy with an electrocautery snare probe for the diagnosis and/or treatment of endobronchial polyps in an interventional pulmonology unit. RESULTS: The mean age of the 47 patients (38 men) with endobronchial polypoid lesions was 61.5 years. Six lesions (12.8%) were located in the trachea, 6 (12.8%) in the right main bronchus, 11 (23.4%) in the left main bronchus, and 24 (51.1%) in the lobar bronchi. Twenty-eight lesions (59.5%) were malignant. Prior to the procedure, 6 (12.8%) patients had grade 1 obstruction, 6 (12.8%) had grade 2 obstruction, 15 (31.9%) had grade 3 obstruction, and 20 (42.6%) had grade 4 obstruction. In terms of airway obstruction after the procedure, grade 1 was present in 46 (97.9%) patients and grade 2 was present in 1 (2.1%) patient. No major complication developed in 93.6% of the patients. During a mean follow-up period of 48 months, 85.1% of the patients did not experience recurrence. CONCLUSION: Our results demonstrate that the snare probe can be used to effectively and reliably establish airway patency in patients with central airway obstruction due to endobronchial polypoid lesions.
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Obstrucción de las Vías Aéreas , Broncoscopía , Electrocoagulación , Pólipos , Humanos , Masculino , Persona de Mediana Edad , Femenino , Electrocoagulación/métodos , Electrocoagulación/instrumentación , Estudios Retrospectivos , Broncoscopía/métodos , Broncoscopía/instrumentación , Anciano , Pólipos/diagnóstico , Pólipos/terapia , Pólipos/patología , Pólipos/cirugía , Obstrucción de las Vías Aéreas/etiología , Obstrucción de las Vías Aéreas/terapia , Obstrucción de las Vías Aéreas/diagnóstico , Adulto , Resultado del Tratamiento , Neoplasias de los Bronquios/diagnóstico , Neoplasias de los Bronquios/cirugía , Neoplasias de los Bronquios/terapia , Anciano de 80 o más AñosRESUMEN
PURPOSE: To report a very rare and atypical case of an elderly Caucasian female patient who developed perilesional multiple polypoidal choroidal vasculopathy (PCV) as a probable complication of choroidal osteoma (CO), associated to preretinal neovascular membrane overlying the lesion. METHODS: Observational case report. CASE OBSERVATION: A 60-year-old Caucasian woman presented with blurred vision in her right eye (RE). Fundus examination revealed a round white-yellowish calcified deep lesion in the juxta-papillary superior area, measuring 4 disc-diameters, with well-defined scalloped margins and an irregular surface. B-scan ultrasonography and orbital tomography confirmed the diagnosis of choroidal osteoma (CO). Further investigation with multimodal imaging including infracyanine green angiography, fluorescein angiography, swept source optical coherence tomography and angiography highlighted the presence of multiple aneurysmal choroidal dilations around the CO, corresponding to PCV. We also noted the presence of a preretinal neovascular membrane overlying the CO. The patient was monitored with regular follow-up since no signs of activity were detected on multimodal imaging. CONCLUSION: Our case report represents an exceptional and atypical association between pre-retinal neovascularization, PCV and choroidal osteoma. While the mechanisms underlying the development of PCV and pre-retinal neovascularization in the setting of CO are not well understood, it is imperative for ophthalmologists to recognize this association as a potential cause of sudden vision loss in patients with CO, and to consider appropriate diagnostic and management strategies.
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Neoplasias de la Coroides , Neovascularización Coroidal , Angiografía con Fluoresceína , Osteoma , Neovascularización Retiniana , Tomografía de Coherencia Óptica , Agudeza Visual , Humanos , Femenino , Persona de Mediana Edad , Osteoma/diagnóstico , Osteoma/complicaciones , Angiografía con Fluoresceína/métodos , Neoplasias de la Coroides/diagnóstico , Neoplasias de la Coroides/complicaciones , Neovascularización Coroidal/diagnóstico , Neovascularización Coroidal/etiología , Neovascularización Coroidal/tratamiento farmacológico , Neovascularización Retiniana/diagnóstico , Neovascularización Retiniana/etiología , Fondo de Ojo , Imagen Multimodal , Coroides/irrigación sanguínea , Pólipos/diagnóstico , Vasculopatía Coroidea PolipoideaRESUMEN
This article presents a rare case of a large hairy polyp, a developmental malformation causing a benign tumor, within the nasopharynx. The patient, born with the polyp obstructing the airway, required immediate intubation and a combined transnasal-transoral surgical approach for excision. The case underscores the challenges in diagnosing and managing such polyps, emphasizing the importance of imaging for surgical planning, and the consideration of multiple approaches to ensure complete resection and prevent recurrence. Laryngoscope, 134:4118-4121, 2024.
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Pólipos , Humanos , Recién Nacido , Pólipos/cirugía , Pólipos/complicaciones , Pólipos/diagnóstico , Femenino , Enfermedades Nasofaríngeas/cirugía , Enfermedades Nasofaríngeas/complicaciones , Enfermedades Nasofaríngeas/diagnóstico , Nasofaringe/diagnóstico por imagen , Nasofaringe/cirugía , Masculino , Obstrucción de las Vías Aéreas/etiología , Obstrucción de las Vías Aéreas/cirugíaRESUMEN
PURPOSE: To compare the visual outcome and fluid features of a proposed biosimilar, CKD-701, versus the reference ranibizumab in eyes with polypoidal choroidal vasculopathy (PCV). METHODS: This was a post hoc analysis of a phase 3 randomized clinical trial assessing the efficacy and safety of CKD-701 and ranibizumab. A total of 73 PCV eyes were assigned randomly to either CKD-701 (36 eyes) or ranibizumab (37 eyes). The mean changes in best-corrected visual acuity (BCVA), central retinal thickness (CRT), pigment epithelial detachment (PED) volume, and fluid features were compared. RESULTS: After three loading injections, the mean change in BCVA (letters) was +7.50 in the CKD-701 group and +6.32 in the ranibizumab group (p = .447). The changes in CRT and PED volume of the CKD-701 group (-107.25 ± 102.66 µm and -0.22 ± 0.46 mm3) were similar to those of the ranibizumab group (-96.78 ± 105.00 µm and -0.23 ± 0.54 mm3) (p = .668 and p = .943, respectively). Proportions of eyes with subretinal, intraretinal and sub-retinal pigment epithelium (RPE) fluids after three loading injections were not different between CKD-701 group (33.3%, 13.9% and 42.9%) and ranibizumab group (51.4%, 16.2% and 40.0%) (p = .071, p = 1.000 and p = .808). The visual and anatomical changes were similar between two groups at month 6 and 12 (all, p > .05). CONCLUSION: Biosimilar CKD-701 monotherapy resulted in comparable visual and anatomical changes to those achieved with reference ranibizumab in PCV eyes.
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Inhibidores de la Angiogénesis , Biosimilares Farmacéuticos , Angiografía con Fluoresceína , Inyecciones Intravítreas , Ranibizumab , Tomografía de Coherencia Óptica , Factor A de Crecimiento Endotelial Vascular , Agudeza Visual , Humanos , Ranibizumab/administración & dosificación , Ranibizumab/uso terapéutico , Agudeza Visual/fisiología , Masculino , Femenino , Inhibidores de la Angiogénesis/uso terapéutico , Inhibidores de la Angiogénesis/administración & dosificación , Anciano , Biosimilares Farmacéuticos/uso terapéutico , Factor A de Crecimiento Endotelial Vascular/antagonistas & inhibidores , Pólipos/tratamiento farmacológico , Pólipos/diagnóstico , Pólipos/fisiopatología , Resultado del Tratamiento , Coroides/irrigación sanguínea , Coroides/patología , Persona de Mediana Edad , Líquido Subretiniano , Estudios de Seguimiento , Fondo de Ojo , Método Doble Ciego , Vasculopatía Coroidea PolipoideaRESUMEN
We report the case of a young man who has never had any sexual contact presenting with a large scrotal lump with secondary bacterial infection. He reported no prior warts - genital or cutaneous. On examination, he had a large pink cauliform mass on the scrotum with four smaller but similar satellite lesions. Appearances were thought to be consistent with giant condyloma of Buschke and Lowenstein. Once superinfection was treated with oral antibiotics, he had a trial of imiquimod without success and was then referred to urology. After surgical excision, pathology concluded it was an inflamed fibroepithelial polyp with no malignant changes. To our knowledge, this is the first case report of a giant scrotal fibroepithelial polyp with characteristic gross warty features in an adult.
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Condiloma Acuminado , Pólipos , Escroto , Humanos , Masculino , Escroto/patología , Pólipos/diagnóstico , Pólipos/patología , Pólipos/cirugía , Condiloma Acuminado/diagnóstico , Condiloma Acuminado/patología , Condiloma Acuminado/cirugía , Diagnóstico Diferencial , Adulto , Neoplasias Fibroepiteliales/diagnóstico , Neoplasias Fibroepiteliales/patología , Neoplasias Fibroepiteliales/cirugía , Resultado del TratamientoRESUMEN
Vulval fibroepithelial polyps (FEPs) are a rare type of vulval fibroblastic tumour commonly found in premenopausal women. It is important to obtain an accurate pathological diagnosis because, despite being benign, the condition shares some characteristics with malignant vulva lesions in its differential diagnosis. We present a case of young woman in her 20s with a giant FEP. After surgical excision, the patient did not manifest any signs of recurrence after 1-year follow-up. Our review focuses on the distinguishing characteristics of these rare neoplasms as we explore their differential diagnosis.
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Neoplasias Fibroepiteliales , Neoplasias de Tejido Fibroso , Pólipos , Neoplasias de la Vulva , Femenino , Humanos , Neoplasias Fibroepiteliales/diagnóstico , Neoplasias Fibroepiteliales/cirugía , Neoplasias Fibroepiteliales/patología , Neoplasias de Tejido Fibroso/patología , Pólipos/diagnóstico , Pólipos/cirugía , Pólipos/patología , Vulva/patología , Neoplasias de la Vulva/diagnóstico , Neoplasias de la Vulva/cirugía , Neoplasias de la Vulva/patología , AdultoRESUMEN
PURPOSE: Endometrial polyps (EPs) are common gynecological disorders for which no clear etiology has been found. ADAMTS have been associated with a variety of diseases. This study aimed to investigate the potential correlation between serologic levels of ADAMTS 5, 9, and 12 in patients with EPs. METHODS: A total of 88 patients were categorized into two groups: the EPs group, consisting of recurrent EPs and first occurrence EPs, and a control group. The study compared the general information and serum levels of ADAMTS 5, 9, and 12 between the groups. RESULTS: Regarding the general data, a statistically significant age difference (p < 0.05) was observed, while no significant differences were found in the other variables. After considering age as a confounding factor, the previously observed statistical significance in the differences of ADAMTS5 and 9 between the groups diminished. However, it was found that the concentrations of ADAMTS12 in both the EPs group and the recurrent EPs group were significantly higher compared to the control group and the first occurrence EPs group (p < 0.05). ROC curves were generated to determine the critical values of ADAMTS12 for predicting EPs and recurrent EPs, which were found to be 0.6962 ng/ml (sensitivity: 100 %, specificity: 39.5 %) and 0.8768 ng/ml (sensitivity: 75.0 %, specificity: 76.3 %), respectively. CONCLUSION: Our findings revealed elevated serologic levels of ADAMTS12 in the EPs group, particularly in the recurrent EPs group. Furthermore, ADAMTS-12 was identified as a valuable biomarker for assisting in the diagnosis and prediction of EPs recurrence.