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Volume 85 - 2022 - Fasc.1 - Case reports

Exceptional manifestation of Madelung’s disease after liver transplantation

Unlike simple obesity, Madelung’s disease (MD) is a rare disease characterized by symmetric accumulation of massive adipose tissue on the neck, the superior part of the trunk and limbs, leading to a pathognomonic cosmetic deformity. Here, we report an extremely rare case of MD associated with bilateral gynecomastia in a 61-year-old man, with a history of recent liver transplantation for alcoholic liver disease (ALD).


Esophageal carcinoma as a portal of entry for brainstem abscess formation

Cerebral abscess formation is a serious and life-threatening clinical entity, secondary to contiguous spread, hematogenous dissemination or direct inoculation. We present the case of a 61-year-old woman with a recent diagnosis of a locally advanced squamous cell carcinoma of the esophagus who was diagnosed with a brainstem abscess. In literature we only found three cases reporting cerebral abscess formation in patients with esophageal carcinoma. Our case report is considered exceptional given the abscess localization in the pons. The abscess was successfully treated with stereotactic drainage and antibiotics. This report emphasizes the importance of gastrointestinal tract evaluation in patients with diagnosis of cerebral abscess when no other cause is found. Brain abscesses must be recognized as a potentially fatal complication of esophageal carcinoma.


High-grade anal intraepithelial neoplasia treated with endoscopic submucosal dissection: a case report

Anal intraepithelial neoplasia is a premalignant lesion for anal squamous cell carcinoma. Current treatment options, consisting of topical therapy and local ablative procedures with electrocautery or radiofrequency ablation, are effective although recurrence rates are high. Experience with endoscopic submucosal dissection for anal lesions is limited, with only a few cases of anal intraepithelial neoplasia and early anal squamous cell carcinoma. We present a 65-year-old woman with high-grade anal intraepithelial neoplasia successfully removed by endoscopic submucosal dissection with no complications or signs of recurrence after 5 months, suggesting that this technique could be a safe and effective approach for management of anal premalignant lesions.


Celiac disease and intussusception – a rare but important association

Most of the cases of intussusception in children are labeled as idiopathic and not usually investigated. Only rare cases of chronic or recurrent intussusception receive greater attention and further investigations. Celiac disease appears to be associated with modestly increased risk of intussusception, although most of these cases remain asymptomatic. Debate still continues as to whether all patients of intussusception should be screened for celiac disease. We present case of a 7 years old child who presented with recurrent intussusception, underwent laparotomy initially and was later diagnosed to have celiac disease.