Aims: Our aim is to describe a case of moderate to severe facial itching associated with missed doses of vilazodone.
Presentation of Case: This report concerns a 53-year old woman with systemic lupus erythematosus and major depressive disorder who experienced sporadic episodes of moderate to severe facial itching around her eyes, cheeks, and forehead after she was prescribed vilazodone.
Discussion: Investigation into the potential causes of the reaction determined that it was not consistent with a SLE malar rash, photosensitivity, hydroxychloroquine-induced lichenoid eruption, or menopausal-related dry skin. The facial pruritus did not respond to antihistamine pharmacotherapy. Symptoms always recurred following missed doses and resolved immediately within 90 minutes after taking the vilazodone. Full compliance with vilazodone has eliminated any further facial itching symptoms.
Conclusion: The authors conclude that vilazodone is the most likely source of the intense pruritus. The reaction occurred consistently after missed doses of the medication and other potential causes were ruled out. This case provides important evidence for health care practitioners to utilize when monitoring and educating of their patients about vilazodone.
Road traffic accidents (RTAs) are changing their presentations over the years, as the type of causative factors evolve. With advent of faster motorbikes and racing cars the RTAs with much greater impact are seen. The most commonly fractured facial bone is the mandible followed by maxilla, zygomatico-maxillary complex, orbital floor, naso-orbitoethamoidal complex, nasal and frontal. One of the important factors determining the success of treatment of midfacial fractures is early and correct diagnosis. Fractures of the coronoid process are uncommon and can easily be missed. The incidence of coronoid process fractures is 1% of all mandibular fractures analyzed. Moreover, the incidence of zygomatic fracture causing fracture of underlying coronoid process is extremely rare. Here we report a rare case of coronoid fracture accompanying zygomatic complex fracture, which was diagnosed solely due to clever 3D CT scan image interpretation.
Over the past 20 years, the treatment for multiple myeloma (MM) has evolved significantly. These pharmaceutical developments allow physicians to combine existing chemotherapy with newly approved novel and targeted medications to create various treatment regimens for MM. These novel drug combinations, immunomodulatory drugs (Thalidomide, lenalidomide and Pomalidomide) and proteasome inhibitors (Bortezomib and carfilzomib), are used upfront for induction therapy as well as for maintenance and treatment of subsequent relapses. However, the emergence of resistant myeloma clones to these drugs is usually inevitable. We describe 2 cases here that demonstrate beneficial response to old traditional chemotherapy combinations after patients become resistant to all novel drugs available. Therefore, our main message is that while novel drugs should be used in frontline combinations to treat MM patients, these novel drugs should not be the last word, and often going back to the old traditional chemotherapy may illicit response and possibly prolong survival.
Manoela Lira Reis, Rafaela Pilon, Aline Costa, Teresa Maria da Silva Figueiredo, Alisson Bigolin, Ana Carolina Rabello de Moraes, Renata Cristina Messores Rudolf de Oliveira, Maria Cláudia Santos da Silva
Malignant pleural effusions (MPE) are common complications in cancer patients and indicate the spread of the primary disease (metastasis). For over a century, malignant effusion has been diagnosed through the observation of changes in the cavity effusion cells, such as the gold-standard cytomorphological analysis. Studies show that the multiparameter flow cytometric analysis is sensitive and rapid and allows for the immunophenotypic evaluation of a large number of cells. This report describes the case of a 64-year-old man diagnosed with lung cancer who had never had any kind of treatment for this disease. The pleural sample was analyzed by morphological (quantitative and differential cytology) and immunocytochemical analyses. As a new tool for diagnosis of malignant pleural effusion, the sample was also analyzed by flow cytometry. In the case report described, flow cytometry was an effective and quick method for detecting neoplastic cells in pleural fluids.
Aims: Endometrial cancer usually occurs after perimenopause and is associated with obesity, diabetes, hypertension, nulliparity, and anovulatory menstrual cycles. Abnormal vaginal bleeding is an early symptom of endometrial carcinoma. We describe our experience with a patient who had endometrial cancer that developed 27 years after radiation therapy for cervical carcinoma, without vaginal bleeding.
Presentation of Case: The patient was a 45-year-old woman with stage IIIB uterine cervical cancer who received radiation therapy. She presented with lower abdominal pain 27 years after treatment. Both transvaginal ultrasonography and magnetic resonance imaging showed a tumor within the uterus. Endometrial biopsy revealed endometrial adenocarcinoma. After placement of a double-J stent, abdominal total hysterectomy and bilateral salpingo-oophorectomy were performed.
Discussion and Conclusion: Our experience shows that endometrial carcinoma can develop 27 years after radiation therapy for cervical cancer. Moreover, patients who have endometrial cancer after radiation therapy might have no abnormal bleeding despite the presence of gross tumor because radiotherapy leads to stenosis and occlusion of the vagina and cervical canal. We should be aware that endometrial adenocarcinoma has an atypical course after radiation therapy; long-term observation is thus essential.
