MyMedR

Papilliferous keratoameloblastoma is an extremely rare variant of ameloblastoma, a benign odontogenic tumor, with only seven cases reported in the English language literature. This variant presents with the metaplastic transformation of stellate reticulum-like cells to the extent of forming papillary structures exhibiting superficial keratinization of varying thickness. This paper describes the pathognomonic macroscopic features of this tumor observed during gross examination under the stereo zoom microscope that differentiate it from the other odontogenic tumors which have not been explored in the previously documented cases. Also, in this paper, a detailed comparison of the macroscopic features observed under the stereo zoom microscope during gross examination with the microscopic features of the histologic section has been described proving to be useful in the histological differential diagnosis of the keratinizing variants of ameloblastoma.

Matched MeSH terms: Diagnosis, Differential

Fulltext Addison's disease presenting with hyperpigmentation

Tong CV, Ooi XY

BMJ Case Rep, 2021 Aug 17;14(8).

PMID: 34404673 DOI: 10.1136/bcr-2021-245610

Matched MeSH terms: Diagnosis, Differential

A typical clinical manifestation of atypical underlying diagnosis: Questions

B N, Cj NA, Mk AM, I MI

Pediatr Nephrol, 2023 Nov;38(11):3611-3613.

PMID: 37160460 DOI: 10.1007/s00467-023-05962-6

Matched MeSH terms: Diagnosis, Differential

Cervicofacial actinomycosis: a key consideration in cases of submandibular swelling

Cheng XL, Abu Hassan NI, Ng DC

BMJ Case Rep, 2023 Dec 09;16(12).

PMID: 38087483 DOI: 10.1136/bcr-2023-258129

Matched MeSH terms: Diagnosis, Differential

An unexpected case of primary peritoneal carcinoma

Nur-Syahrina R, Siti-Aishah MA, Swaminathan M, Ng PH, Ismail S, Syazarina SO, et al.

Clin Ter, 2010;161(3):261-3.

PMID: 20589359

Primary peritoneal carcinoma (PPC) is a rare tumor that is histologically and immunohistochemically indistinguishable from epithelial ovarian carcinoma. The diagnosis is usually made after excluding gross ovarian involvement or the ovarian involvement is only confined to the surface. A 68-year-old lady presented with right iliac fossa pain and increasing CA125. The CT scan showed bilateral pelvic adnexal masses with peritoneal deposits within the right side of abdomen. She was initially diagnosed as carcinomatosis peritonei from the omental cake removed after exploratory surgery. She was managed as advanced ovarian tumor with peritoneal metastasis and was then administered six cycles of chemotherapy. Surgical intervention included debulking surgery consisting of total abdominal hysterectomy, bilateral salpingooophorectomy and omentectomy and also with right hemicolectomy. The histopathological findings were of primary peritoneal serous carcinoma with only minimal involvement of the serosal surface of the right ovarian capsule. No microscopic invasion into underlying ovarian cortex and stroma was observed. Multiple tumor deposits were also seen over the right paratubal and paraovarian tissue, both parametrium as well as serosal surface of the terminal ileum and periappendicular tissue. Immunohistochemically, the malignant cells were positive to CA125, focally positive to CK7 and negative to CD20 and Calretinin. PPC is one of important differential diagnosis which needs to be considered in cases of advanced ovarian tumor, although the former can only be ascertained after excluding the ovarian involvement microscopically.

Matched MeSH terms: Carcinoma/diagnosis*; Diagnosis, Differential; Ovarian Neoplasms/diagnosis; Peritoneal Neoplasms/diagnosis*

Fulltext Tubercular synovitis mimicking rheumatoid nodules

Teo SC, George J, Kamarul T

Med J Malaysia, 2008 Jun;63(2):159-61.

PMID: 18942309 MyJurnal

Tubercular tenosynovitis is an uncommon condition and usually affects the upper limb. We report a case of a patient with Systemic Lupus Erythematosus who presented with wrist swelling. The clinical findings were suggestive of rheumatoid nodules, but the radiographic finding of calcification associated with the nodules and marked erosive changes primarily of the radio-carpal joint with sparing of the metacarpal joints led the radiologist to believe that the nodules may not be rheumatoid nodules. The presence of solid and fluid nature of the nodule and hyperechoic small echogenic foci (matted rice bodies within thickened synovium) on ultrasound suggested the presence of chronic synovitis of tuberculous infection rather than rheumatoid nodule as in our case. We recommend the use of ultrasound to determine the nature of nodular swellings seen clinically in patients with arthropathy.

Matched MeSH terms: Diagnosis, Differential; Rheumatoid Nodule/diagnosis*; Synovitis/diagnosis*; Tuberculosis, Osteoarticular/diagnosis*

Fulltext Leiomyoma of the caecum presenting as peritonitis

Mack P, Nambiar RM

Med J Malaysia, 1987 Dec;42(4):299-301.

PMID: 3454402

Leiomyoma of the caecum is a rare tumour. While leiomyomata are known to arise from any part of the large bowel, caecum is a rare site. The largest series to date is that of Mackenzie" who reviewed 37 cases of myomatous tumours of the colon, two of which were complicated by perforation. More recently, Swerdlow" reported another case of a perforated caecal leiomyoma. We now report a patient who was operated at the stage of abscess formation without perforation.

Matched MeSH terms: Cecal Neoplasms/diagnosis*; Diagnosis, Differential; Leiomyoma/diagnosis*; Peritonitis/diagnosis*

Fulltext Authors' Reply. A different viewpoint on pneumococcal glomerulonephritis in a healthy child

Ismail IH, Zainudin Z, Othman N

Singapore Med J, 2014 Sep;55(9):506.

PMID: 25273938

Matched MeSH terms: Glomerulonephritis/diagnosis*; Lymphadenitis/diagnosis*; Pneumococcal Infections/diagnosis*; Bacteremia/diagnosis*

Fulltext Melioidosis presenting as epididymo-orchitis

Koh KB

Singapore Med J, 1995 Aug;36(4):446.

PMID: 8919168

We report a rare case of suppurative epididymo-orchitis caused by Pseudomonas pseudomallei in a 56-year-old male. This is a gram negative bacillus found mainly in tropical zones. Diagnosis was reached by culture of the organisms after drainage of the scrotal abscess, and the patient was treated by a course of oral chloramphenicol 500 mg qid for 6 months.

Matched MeSH terms: Diagnosis, Differential; Epididymitis/diagnosis*; Melioidosis/diagnosis*; Orchitis/diagnosis*

Sarcoid Myopathy Mimicking Polymyositis: A Case Report and Pool Analysis of the Literature Reviews

Sazliyana Shaharir S, Jamil A, Kosasih S, Soo Fin L, Sridharan R, Hayati Md Pauzi S

Acta Med Iran, 2017 Dec;55(12):800-806.

PMID: 29373888

A 59-year-old man presented with proximal myopathy, myalgia, and weight loss, with the initial markedly elevated serum creatine kinase at 11,000 U/L. Due to his refusal for muscle biopsy, he was initially treated as inflammatory myositis and responded well with the corticosteroids. However, he subsequently had a relapse of the symptoms with more extensive systemic involvement, i.e., hypercalcemia, lymphadenopathy and subcutaneous nodules. Finally, a biopsy of the thigh and subcutaneous nodule revealed non-caseating granulomatous inflammation, consistent with sarcoidosis. He responded well to the corticosteroids, and finally, azathioprine was added as a steroid-sparing agent. Including our series, there are 103 cases of symptomatic muscle involvement in sarcoidosis patients published in the English literature to date. Further pool analysis of the cases will be reported in this review.

Matched MeSH terms: Diagnosis, Differential; Granuloma/diagnosis; Muscular Diseases/diagnosis; Myositis/diagnosis*; Sarcoidosis/diagnosis*; Polymyositis/diagnosis*

Fulltext The importance of considering sebaceous gland carcinoma in presumed chalazia in South Asian patients?

Sagili S, Malhotra R

Br J Gen Pract, 2013 Feb;63(607):74.

PMID: 23700655

A 51-year-old Malaysian female was referred with a left lower eyelid lesion noticed 4 years ago. She consulted her GP a year ago and was diagnosed to have a chalazion. Her GP requested funding for treatment. The primary care trust (PCT) considered this a low-priority procedure and declined funding. One year later she approached her GP again and was referred to a hospital for management of this eyelid lesion (Figure 1). She underwent a biopsy and the histology was suspicious of a squamous cell carcinoma. She was referred to our unit. On examination, she had a left lower eyelid, firm 4mm nodule with thickening and distortion of tarsal conjunctiva. With a clinical suspicion of sebaceous gland carcinoma (SGC), a wedge excision of the lesion was performed. Paraffin section histology confirmed complete excision of SGC. Delayed repair required a Tenzel flap. She remains asymptomatic at 5-month follow-up.

Matched MeSH terms: Carcinoma, Squamous Cell/diagnosis*; Diagnosis, Differential; Sebaceous Gland Neoplasms/diagnosis*; Chalazion/diagnosis*; Adenocarcinoma, Sebaceous/diagnosis*

Dens evaginatus on a wisdom tooth: a diagnostic dilemma. Case report

Ngeow WC, Chai WL

Aust Dent J, 1998 Oct;43(5):328-30.

PMID: 9848984

Pericoronitis is the most common odontogenic problem associated with the wisdom tooth in young men and women. Patients may present with problems associated with infection, swelling and pain. However, other associated pathology such as caries, periodontal disease and referred pain from the temporomandibular joint must be investigated when treating pain from the wisdom tooth. The authors wish to present a case in which the pain from a wisdom tooth was due to a fractured dens evaginatus. The importance of this dental anomaly should not be overlooked.

Matched MeSH terms: Diagnosis, Differential; Pericoronitis/diagnosis; Pulpitis/diagnosis; Tooth Fractures/diagnosis*; Toothache/diagnosis

Fulltext A case of left atrial myxoma

Segasothy M

Med J Malaysia, 1982 Sep;37(3):221-2.

PMID: 7177002

Left atrial myxoma almost always arises in the inter-atrial septum. A case is described where it arose from the posterior wall of the left atrium. Clinical presentation was suggestive of mitral stenosis and sub-acute bacterial endocarditis and diagnosis was arrived at necropsy.

Matched MeSH terms: Diagnosis, Differential; Endocarditis, Subacute Bacterial/diagnosis; Heart Neoplasms/diagnosis*; Mitral Valve Stenosis/diagnosis; Myxoma/diagnosis*

Fulltext Ultrasound and abdominal masses

Md Alif AK

Med J Malaysia, 1982 Mar;37(1):82-7.

PMID: 7121355

Matched MeSH terms: Abdominal Neoplasms/diagnosis*; Liver Neoplasms/diagnosis

Strawberry Marks on Lip

Kanneppady SS, Kanneppady SK, Chaubal T, Bapat R, Pandurangappa R, Oo AM, et al.

Am J Med, 2019 04;132(4):e538-e539.

PMID: 30503886 DOI: 10.1016/j.amjmed.2018.11.019

Matched MeSH terms: Hemangioma/diagnosis*; Lip Neoplasms/diagnosis*

Retroperitoneal teratoma

Mohd Bahari HM, Haron A

Med J Malaysia, 1979 Mar;33(3):226-9.

PMID: 522727

Matched MeSH terms: Retroperitoneal Neoplasms/diagnosis*; Teratoma/diagnosis*

Acute Hemorrhagic Edema of Infancy: A Diagnostic Challenge for the General Pediatrician

Leung AKC, Leong KF, Lam JM

Curr Pediatr Rev, 2020;16(4):285-293.

PMID: 32718294 DOI: 10.2174/1573396316666200727145039

BACKGROUND: Acute hemorrhagic edema of infancy (AHEI), a benign and self-limited disease, can be easily mistaken to be a number of diseases with similar dermatological manifestations but with potentially adverse outcomes.

OBJECTIVE: This review aimed to familiarize pediatricians with the natural history, clinical manifestations, diagnosis, and management of AHEI.

METHODS: A PubMed search was conducted in February 2020 in Clinical Queries using the key terms "acute hemorrhagic edema of infancy" OR "Finkelstein disease" OR "Seidlmayer disease". The search strategy included meta-analyses, randomized controlled trials, clinical trials, observational studies, and reviews published within the past 10 years. Only papers published in the English literature were included in this review. The information retrieved from the above search was used in the compilation of the present article.

RESULTS: AHEI, a rare cutaneous leukocytoclastic small-vessel vasculitis, typically presents with palpable purpura, peripheral acral edema, and frequently with fever, most often in children between 4 and 24 months of age. A significant number of children experience prodromal symptoms of an upper respiratory infection. Fever is typically low grade and is present in approximately 50% of cases. The cutaneous lesions are characterized by rapid onset of small erythematous macules or papules that progress to well demarcated, annular, rosette, medallion-like, or targetoid purpuric plaques or ecchymosis in 24 to 48 hours. The skin lesions are typically palpable, nonpruritic, and symmetrically distributed. Sites of predilection include the face, auricles, and extremities. Edema is typically nonpitting and asymmetrical and occurs primarily on the dorsum of the hands and feet, the face, and the auricles. In spite of the acuteness and extent of the cutaneous findings, the child looks well and nontoxic. Systemic and/or visceral involvement are rare. The differential diagnosis is broad and includes, among others, Henoch-Schönlein purpura. It is crucial to distinguish AHEI from the other diseases since the management of these diseases is quite different. The clinical features of mimickers of AHEI are reviewed and clues to differentiate AHEI from these mimickers are highlighted..AHEI is a benign, self-limited disease with complete spontaneous recovery in one to three weeks in the majority of cases.

CONCLUSION: Recognizing this rare disease is important for the pediatrician to rapidly differentiate AHEI from other potentially serious diseases that require prompt therapy and monitoring. With rapid recognition of AHEI, unnecessary investigations and inappropriate interventions can be prevented and parental anxiety can be avoided.

Matched MeSH terms: Diagnosis, Differential; Edema/diagnosis

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