Aperito Journal of Case Reports Clinical

Imaging of the inner ear structures is becoming essential nowadays as the increasing number of cases of cochlear implants being performed globally. We report here a case of a 19-year-old boy who had congenital hearing loss and was being evaluated in our service for possible cochlear implantation. Audiometry showed profound mixed sensorineural hearing loss of the right side and mild to moderate conductive hearing loss in the left side. The magnetic resonance imaging revealed only two nerves in the narrowed right inner auditory canal: one in the anterior superior quadrant, identified as the facial nerve, and one on the posterior quadrants, representing the incomplete separation of the superior and inferior vestibular nerves which is an anatomical variant. Bilateral lateral semicircular canals were not visualized and there is dysplastic vestibules morphology. The diagnosis for the patient was right cochlear nerve agenesis with bilateral lateral semicircular canals aplasia. 

Plasmacytoma is a rare malignant disease based of differentiated plasmatic B cells, which occurs also in the head and neck region. It rarely involves the mandible. The authors present an unusual evaluation of this pathology through a clinical case of a 45 year old patient diagnosed with solitaty plasmocytoma in the Temporomandibular Joint (TMJ) region. The solitary tumor was located in the area between the muscular and articular process of the left side of the mandible. Resection of the tumour and articular process was performed under general anesthesia. Histopathology revealed sheets of plasma cells with cartwheel appearance and expansive bone trabecula – plasmacytoma of the mandible. Complementary treatment was performed by four cycles of systemic chemotherapy. The tumor recurrence was diagnosed after three year during control MRI examination. The 
patient underwent autologous cell transplantation from his brother without any surgical treatment. In the three-year follow up the patient didn’t show local progression of the tumour. The oncologist did not recommend another surgery. Five year post operation and chemotherapy patient died for gastrointestinal complication

Osteochondroma or bony exostosis is a common benign tumor of bone occurring predominantly in long bones. It may arise infrequently from the spine giving rise to vague symptoms as backache or may lead to compressive myelopathy due to cord compression. Malignant transformation is noted in very few cases of solitary osteochondroma. The authors are presenting a rare case of solitary osteochondroma arising from thoracic spine presenting as backache during sleep in supine posture in a young patient.  

A polypoid, or submucosal tumor-like, presentation of Mucosa-Associated Lymphoid Tissue (MALT) lymphoma is relatively rare, while correct clinical and histopathological diagnoses of such cases are important for patients in order to avoid unnecessary advanced surgical intervention. We reported an 88-year-old gentleman with a low-stage MALT lymphoma, presenting with a polypoid subepithelial tumor on endoscopy. The present case would bring attention to both clinicians and pathologists that gastric MALT lymphoma could present as a long-standing, polypoid subepithelial tumor, and the patient should be managed conservatively with medical treatment or localized radiotherapy.

We report the use of dabigatran was found to be associated with Factor VIII inhibitors and prolonged APTT in the three cases. Taking the dabigatran was recognized prolonged APTT, low titer Factor Ⅷ inhibitors and reduction of Factor Ⅷ. Once these cases stopped dabigatran in a variety of causes. At the time of dabigatran discontinuation, APTT was normal value and Factor Ⅷ, Factor Ⅷ inhibitor became the normal value. When dabigatran resumed. APTT was prolonged and low titer Factor Ⅷ inhibitors and reduction of Factor Ⅷ. Side effects of bleeding at the time of APTT prolongation was not admitted in three cases.