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  • ISSN: 2373-9819
    Volume 6, Issue 4
    Case Report
    Dylan M. Johnson*, Levi J. White, Brenda Cruciani, and Stephen V. Gordon
    Pseudoepitheliomatous hyperplasia (PEH) is a benign skin disease associated with reactivity to chronic inflammation. The diagnosis is based upon histologic characteristics and thus requires a formal biopsy. Due to its ambiguity, particularly the range of other conditions in which it is associated, a report of PEH instills much difficultly upon the receiving clinician in deciding further management, especially if malignancy had not been discounted prior to the biopsy. The risk of causing unnecessary iatrogensis by obtaining additional biopsies must be weighed with the potential consequence of anchoring to a diagnosis of PEH that reveals it to have been falsely reassuring. If one finds themselves in such a situation when caring for a patient, due diligence is warranted. Determining whether or not additional studies are appropriate should not be taken lightly with a diagnosis of PEH, as the decision may result in significant consequences.
    Sakshi Nayar*, Minu Keshkar, Aparna Arya, and Manju Puri
    Gestational gigantomastia is a rare condition of unknown etiology with psy-chological and physical adverse effects on the mother. Our case presented as an unbooked case at 37 weeks of gestation and was managed conservatively till delivery followed by spontaneous resolution post delivery.
    Usama Nasir*, Muhammad Ali Tariq, Haris Chaudhry, Cesar Figueroa, Maira Nusrat and Saher Aslam
    Insulin replacement therapy is one of many treatment options that can help to bring about near normoglycemia in patients with type 2 diabetes mellitus (T2DM).Adverse effects of human insulin and its analogs are common and are a significant issue in current diabetes care. However, polyarthralgias on long acting insulin, especially Insulin Glargine is a side effect that has previously never been reported. Here, we present an interesting case of a 61-year-old male patient, who was diagnosed with type two diabetes at the age of 41. The patient was compliant with basal-bolus insulin therapy and his basal insulin was recently changed to Insulin Glargine. In the immediate follow up after this change, the patient reported progressively worsening polyarthralgias necessitating Insulin Glargine to be discontinued. It was assumed that the new Insulin was the cause since the patient returned to his normal state of health upon its discontinuation. This is the first documented case of polyarthralgias on Insulin Glargine therapy in an adult patient. The literature does not have much to offer regarding this paradox and so the exact pathophysiology remains unknown.
    Michael Schmidt*, Alec Raniwsky, Abigail Sebald, Eason Balakrishnan, and Mohamed Aziz
    Leiomyosarcoma of the testis is extremely rare. We present the case of a 42-year-old male with a firm right para-testicular mass who underwent a radical wide margin orchiectomy. Histological examination revealed a high-grade leiomyosarcoma.
    Ricardo Villasmil*, Nicole Asher, Amy Town, and Mohamed Aziz
    Malignant mesothelioma (MM) is a rare and highly aggressive neoplasm primarily of the pleura with a poor prognosis principally due to its late presentation. Differentiation of malignant cells from reactive benign cells in ascitic and pleural effusions can be challenging and may lead to diagnostic errors. Even after malignant cells are identified, it is equally challenging to differentiate malignant mesothelial from malignant epithelial cells. Diagnosis should be based on cytological evaluation and confirmation utilizing immunohistochemistry studies. We report the case of a 44-year-old patient diagnosed with malignant mesothelioma. Initial cytomorphology assessment was suggestive of adenocarcinoma (clusters with community border). However, with utility of immunohistochemistry studies for confirmation, the final diagnosis proved to be malignant mesothelioma and not adenocarcinoma. The diagnosis was confirmed using immunohistochemical studies even in the presence of strong cytomorphological features.
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