Brazilian Journal of Case Reports <p><strong>Aims &amp; Scope</strong></p> <p>The <strong><em>Brazilian Journal of Case Reports</em> (BJCR) (ISSN 2763-583X)</strong> is an international, <span class="VIiyi" lang="en"><span class="JLqJ4b ChMk0b" data-language-for-alternatives="en" data-language-to-translate-into="pt" data-phrase-index="0">open access, </span></span><span class="VIiyi" lang="en"><span class="JLqJ4b ChMk0b" data-language-for-alternatives="en" data-language-to-translate-into="pt" data-phrase-index="0">quarterly publication with continuous editorial and publication flow, and </span></span>double blind peer-reviewed publication featuring original contributions of interest to <strong>human and animal health researchers</strong>. Since 2021 <span class="VIiyi" lang="en"><span class="JLqJ4b ChMk0b" data-language-for-alternatives="en" data-language-to-translate-into="pt" data-phrase-index="0"><strong>BJCR</strong> focuses on the dissemination of clinical studies that demonstrate rare and important findings that stand out in the medical field, whether human or animal.</span></span> The Journal features the following sections (all topics may related with human or animal studies):</p> <ul> <li><strong><em>Clinical Case Reports;</em></strong></li> <li><strong><em>Clinical Imagens Reports;</em></strong></li> <li><strong><em>Letter to editor (Correspondence or Comments).</em></strong></li> </ul> <div class="publication-metric"><strong>Time to first decision: </strong>Two weeks.</div> <div class="publication-metric"> </div> <div class="publication-metric"><strong>Language: </strong><span class="static-information"><strong>English</strong> is the official language of <strong>BJCR</strong>. <span class="VIiyi" lang="en"><span class="JLqJ4b ChMk0b" data-language-for-alternatives="en" data-language-to-translate-into="auto" data-phrase-index="0">However, we will also receive articles in <strong>Portuguese</strong>.</span></span></span></div> <div class="publication-metric"> </div> <div class="publication-metric"><strong>Aims and Scope</strong></div> <p>BJCR will consider any original case report that expands the field of general medical knowledge about human and/or veterinary sciences, and original review studies relating to clinical case reports.</p> <p><span class="VIiyi" lang="en"><span class="JLqJ4b ChMk0b" data-language-for-alternatives="en" data-language-to-translate-into="pt" data-phrase-index="0">All articles in the BJCR may follow</span></span> one of the following topics, but not necessarily (all topics may related with human or animal studies):</p> <ul> <li><strong><em><span class="VIiyi" lang="en"><span class="JLqJ4b ChMk0b" data-language-for-alternatives="en" data-language-to-translate-into="pt" data-phrase-index="0">Rare clinical findings;<br /></span></span></em></strong></li> <li><strong><em><span class="VIiyi" lang="en"><span class="JLqJ4b ChMk0b" data-language-for-alternatives="en" data-language-to-translate-into="pt" data-phrase-index="0"> Clinical images (ie. X-ray, CT scans, MRIs, and ultrasound);</span></span></em></strong></li> <li><strong><em><span class="VIiyi" lang="en"><span class="JLqJ4b ChMk0b" data-language-for-alternatives="en" data-language-to-translate-into="pt" data-phrase-index="0">Clinical Laboratory findings (ie. blood analysis, and histopathology);</span></span></em></strong></li> <li><strong><em>Pathology diagnosis;</em></strong></li> <li><strong><em>Surgery procedures;</em></strong></li> <li><strong><em>Health Education.</em></strong></li> </ul> <p><strong><span class="VIiyi" lang="en"><span class="JLqJ4b ChMk0b" data-language-for-alternatives="en" data-language-to-translate-into="pt" data-phrase-index="0">Article Processing Charges</span></span></strong></p> <p><span class="VIiyi" lang="en"><span class="JLqJ4b ChMk0b" data-language-for-alternatives="en" data-language-to-translate-into="pt" data-phrase-index="0">All articles published in <strong>BJCR</strong> are open access and freely available online, immediately upon publication. APC is essential </span></span><span class="VIiyi" lang="en"><span class="JLqJ4b ChMk0b" data-language-for-alternatives="en" data-language-to-translate-into="pt" data-phrase-index="0">to cover the costs of all journal publishing functions. The APC for <strong>BJCR</strong> is <strong>USD120,00</strong>, <em>for foreign authors</em>, or <strong>R$500,00</strong> <em>for Brazillian authors</em>. </span></span><span class="VIiyi" lang="en"><span class="JLqJ4b ChMk0b" data-language-for-alternatives="en" data-language-to-translate-into="pt" data-phrase-index="0">There are no charges for <em>Letter to editor</em>, submission or rejected articles, and no surcharges based on the article composition (ie. color figures or number of pages).</span></span></p> <p><strong><span class="VIiyi" lang="en"><span class="JLqJ4b ChMk0b" data-language-for-alternatives="en" data-language-to-translate-into="pt" data-phrase-index="0">Scientific Mission</span></span></strong></p> <p><span class="VIiyi" lang="en"><span class="JLqJ4b ChMk0b" data-language-for-alternatives="en" data-language-to-translate-into="pt" data-phrase-index="0"><span class="Q4iAWc">Our mission is the publication and digital visibility of national and international scientific research in the health area, with a focus on open access publications, which seek to disseminate the results of relevant scientific studies, peer-reviewed by a qualified editorial board, valuing quality, impact and its scientific and social relevance.</span></span></span></p> <p><span class="VIiyi" lang="en"><span class="JLqJ4b ChMk0b" data-language-for-alternatives="en" data-language-to-translate-into="pt" data-phrase-index="0">If you have any questions, please do not hesitate to contact us at <strong> </strong>or by Whatsapp (+55853038-4127).</span></span></p> Publicações Científicas de Acesso Aberto - PCAA en-US Brazilian Journal of Case Reports 2763-583X Metatarsal Sesamoids: Borges-Napoleon Sign <p>The metatarsal sesamoids have been well studied due to their consistent presence in humans and relatively common involvement in foot pathologies. The manifestations of sesamoid lesions on imaging depend on the nature of the pathology and generally overlap. During observation in sectional examinations, an anatomical pattern sign of the sesamoid bones of the first metatarsal was identified to be assessed by specialists in diagnostic imaging to note alterations that deviate from this anatomical pattern sign. Would the anatomical pattern sign in question help in the diagnosis of pathological alterations once it has been de-characterized? The presentation of the Borges-Napoleon sign characterizes the normality of the bones involved in the image, making it safe to diagnose pathological alterations that compromise their structure. Therefore, presenting this idealization could help improve medical reports. The sign is described as the "Borges-Napoleon Sign" because of its resemblance to the silhouette of the Frenchman Napoleon Bonaparte and in reference to the creator of the imaging description, Yuri Borges Morais. Pathological alterations such as traumatic injuries, sesamoiditis, dislocations, fractures, and hallux valgus ("bunions"), among others, de-characterize the Borges-Napoleon sign; the absence of the sign is indicative of an abnormality in the metatarsal-sesamoid-phalangeal region.</p> Yuri Borges Morais Levy da Costa Felix Jones Aguiar de Azevedo Copyright (c) 2024 Brazilian Journal of Case Reports 2024-05-14 2024-05-14 4 4 118 125 10.52600/2763-583X.bjcr.2024.4.4.118-125 Issue Information Howard Lopes Ribeiro Junior Copyright (c) 2024 Brazilian Journal of Case Reports 2024-06-14 2024-06-14 4 4 1 2 10.52600/2763-583X.bjcr.2024.4.4.1-2 Variantes genéticas em criança com pancreatite aguda recorrente: um relato de caso <p class="s5"><span class="s6">Pancreatite aguda recorrente é definida por dois ou mais episódios distintos de pancreatite aguda com ausência de manifestações e alterações laboratoriais no intervalo entre os quadros. Estudos multicêntricos identificaram três principais genes associados a esses quadros: PRSS1; SPINK1 e CFTR. </span>O presente estudo descreve o caso de uma paciente de 3 anos com duas internações por pancreatite aguda, em que a investigação etiológica identificou variações nos genes PRSS1 e CFTR. Mutações genéticas são mais prevalentes no sexo feminino e pacientes com história familiar de pancreatite. Constituem fatores de risco para desenvolvimento precoce de pancreatite crônica, além de Diabetes Mellitus e câncer de pâncreas. A pancreatite aguda recorrente causa impacto na qualidade de vida e na saúde mental, devido à dor crônica e repetidas hospitalizações. A identificação de alterações genéticas auxilia no seguimento desses quadros, previne complicações e evita a realização de procedimentos desnecessários.</p> Carolina Dorigon Bantle Mateus Mendonça Vargas Fabiana Fornazieri Martins Scardelato Giovana Güntzel Vidigal Copyright (c) 2024 Brazilian Journal of Case Reports 2024-01-25 2024-01-25 4 4 3 7 10.52600/2763-583X.bjcr.2024.4.4.3-7 Clinical manifestation and diagnostic challenges of SAPHO Syndrome: a case report <p>The SAPHO syndrome, characterized by synovitis, acne, pustulosis, hyperostosis, and osteitis, is a rare disease of unknown prevalence and probably underdiagnosed. Its diagnosis can be confirmed by correlating the clinical symptoms with the radiological findings. However, it is challenging to do so since the clinical manifestations of this disease are diverse, with no confirmatory serological marker, and the radiological alterations can be nonspecific. This study is aimed to report the case of a patient with SAPHO syndrome, with an unusual clinical presentation, and the challenges faced to establish the diagnosis.</p> Thami Ellen Busanello Spanevello Lucas Teodoro Rodrigues Márcia Regina Rosa Scalcon Copyright (c) 2024 Brazilian Journal of Case Reports 2024-02-07 2024-02-07 4 4 8 11 10.52600/2763-583X.bjcr.2024.4.4.8-11 Renal artery pseudoaneurysm after renal biopsy: case report <p>Renal artery pseudoaneurysm (RAP) is a rare and potentially serious complication that can occur after renal biopsy procedures. We present the case of a 37-year-old patient who developed RAP after a renal biopsy, presenting signs of hypovolemic shock shortly after the procedure without signs of hematuria. A computed tomography scan of the abdomen was performed which revealed a significant perirenal hematoma and RAP formation. The patient underwent endovascular embolization, which successfully controlled the hemorrhage. After 6 months of evolution, a small degree of renal atrophy was identified, a known complication following embolization. This case report highlights the importance of early recognition and appropriate management of RAP following renal biopsies and provides information on diagnostic and treatment approaches for this uncommon complication.</p> André Frizon Rodrigo Bello Mauricio Macagnan Larissa Voss Esther Schaffel Copyright (c) 2024 Brazilian Journal of Case Reports 2024-02-09 2024-02-09 4 4 12 17 10.52600/2763-583X.bjcr.2024.4.4.12-17 Aortoesophageal fistula with formation of secondary aortic pseudoaneurysm due to esophageal neoplasia: case report <p><span style="font-weight: 400;">Aortoesophageal fistula as a cause of upper gastrointestinal bleeding is a very rare event with a high immediate mortality rate. Some of the causes include foreign bodies, post-surgical complications, and malignancy. The following case describes how esophageal cancer invaded the walls of the descending aorta, leading to the formation of a pseudoaneurysm that subsequently fistulized into the esophagus, secondary to radiotherapy treatment. This case highlights the importance of evaluating the thoracic aorta before and during radiotherapy treatments, to investigate the existence of aortic vascular compromise adjacent to the esophagus. If the existence of an aortic pseudoaneurysm is detected, radiotherapy treatment should be suspended until the pseudoaneurysm is corrected, reducing the lethality of patients undergoing advanced treatments.</span></p> André Frizon Esther Heloisa Schaffel Francisco Donato Rodrigo Bello Mauricio Rizzi Macagnan Fábio Goulart da Silva Henrique Rosa Sobrinho Copyright (c) 2024 Brazilian Journal of Case Reports 2024-02-15 2024-02-15 4 4 18 22 10.52600/2763-583X.bjcr.2024.4.4.18-22 Bronchiolitis in an infant due to influenza A, necropsy findings: a case report <p>The influenza virus is an important cause of respiratory disease in infants and presents challenging differential diagnoses to investigate. This is a case report that involves a necroscopic study of a 2-month-old male infant, without previous comorbidities, with a serological diagnosis of influenza A and histopathological presentation of non-obliterating bronchiolitis. Infants are considered a high-risk group for flu complications due to the immaturity of the immune system and the ability to respond to respiratory infections. Furthermore, the severity of infection in infants may be worsened by the difficulty in quickly considering and treating the symptoms of the disease.</p> Daniela Cristina dos Santos Souza Diego Henrique Ferreira Mussatto Paula de Almeida Souza Santos da Costa Ellen Diniz de Menezes Magno Giovani Zanelatto Marcelo Padovani de Toledo Moraes Maria Aparecida Custodio Domingues Pedro Marciano de Oliveira Simone Antunes Terra Elida Paula Benquique Ojopi Copyright (c) 2024 Brazilian Journal of Case Reports 2024-02-21 2024-02-21 4 4 23 33 10.52600/2763-583X.bjcr.2024.4.4.23-33 Tríade terrível do cotovelo associada a avulsão do tendão do tríceps braquial e da massa flexo-pronadora: relato de caso <p>A tríade terrível do cotovelo é uma lesão complexa, caracterizada por luxação póstero-lateral da articulação ulno-umeral e fraturas da cabeça do rádio e do processo coronoide na ulna. O tratamento é predominantemente cirúrgico e suas principais complicações são a instabilidade ou rigidez articular, pseudoartrose, artrose pós-traumática, dor persistente e limitação funcional. O objetivo desse relato de caso é descrever um tipo de apresentação raro de TTC com lesões concomitantes da inserção do tendão do tríceps braquial e da origem da massa flexo-pronadora, cujo diagnóstico foi realizado através de uma incisão não convencional, a posterior universal do cotovelo.</p> Thalles Leandro Abreu Machado Lucas de Melo Castro Deligne José Carlos Souza Vilela Tadeu Fonseca Barbosa Mateus Antunes Percopi de Andrade Thiago Dourado Duarte Copyright (c) 2024 Brazilian Journal of Case Reports 2024-03-08 2024-03-08 4 4 34 39 10.52600/2763-583X.bjcr.2024.4.4.34-39 Hirayama Disease: a Case Report with Late Onset <p>The etiology of Hirayama's disease (HD) is still controversial, but the most accepted mechanism is the repetition of sudden neck flexion movements, which causes a flattening of the cervical spinal cord. It reaches the cells of the anterior tip of the medulla in the C7-T1 segments. 45-year-old patient with HD, diagnosed 1 year ago with typical atrophy of the left upper limb (LUL) associated with fasciculation and decreased osteotendinous reflexes in upper limbs (ULL). Due to the rarity of the disease, there are many underdiagnosed cases, which results in low epidemiological data reported. We are aware that the prevalence in males is explained by accelerated growth at puberty.</p> Antônio Marco Duarte de Albuquerque Sarah Câmara Ferreira Sophia Alves de França Silva Rodrigo Araújo de Melo Copyright (c) 2024 Brazilian Journal of Case Reports 2024-03-20 2024-03-20 4 4 40 42 10.52600/2763-583X.bjcr.2024.4.4.40-42 Exceptional Case of Spontaneous Ovarian Hyperstimulation Syndrome in Complete Molar Pregnancy: A Case Study <p>Spontaneous ovarian hyperstimulation syndrome (OHS) is an uncommon condition. We report the case of a 38-year-old woman admitted to the emergency department with vaginal bleeding, pelvic pain, and an extraordinarily high human chorionic gonadotropin (hCG) level of 1,000,000 mIU/mL. Uterine aspiration confirmed a complete hydatidiform mole. Ten days post-discharge, she returned, exhibiting severe abdominal pain, vomiting, an hCG level of 46,769 mIU/mL, and ultrasound evidence of theca lutein cysts (right ovary: 1329 cm³; left ovary: 500 cm³) along with ascites. Suspected of having OHS, she was hospitalized for clinical management. Treatment included intravenous hydration, analgesia, thromboprophylaxis, and daily laboratory tests, leading to symptomatic improvement despite rising hCG levels. After a 35-day hospital stay, she commenced chemotherapy at a specialized cancer hospital. This case emphasizes the importance of healthcare professionals being alert and aware of the possibility of this diagnostic suspicion in such cases, particularly highlighting the need for hospitalization in moderate to severe instances.</p> Juliana Barbosa Guimarães Adriana Bruno Márcia Maria Pedreira da Silveira Andrea Railla Nogueira Rodrigues Milena Bastos Brito Copyright (c) 2024 Brazilian Journal of Case Reports 2024-03-24 2024-03-24 4 4 43 49 10.52600/2763-583X.bjcr.2024.4.4.43-49 Case Report on a Supracondylar Process of the Humerus: Morphological and Morphometric analysis <p class="MDPI17abstract"><span lang="EN-US" style="color: windowtext;">The supracondylar process is a rare anatomical variation characterized by an irregular bone prominence with a variable size. Found in the anteromedial part of the distal region of the humerus, can compress the median nerve and other structures. The aim of this paper was to perform a morphological and morphometric evaluation of this variation in a right dry humerus. Faces, margins, and shape of the process were observed. Measurements was taken from the process and the entire bone. The apex of the process points toward the transition between the trochlea and the humeral capitulum. The bony spicule was 6.24 mm long. The base of the spicule measured 6.80 mm in length and 4.18 mm in width. Longitudinal crests associated with the base of the process and a deep longitudinal depression were observed. The combined longitudinal length of the caudal and cranial crests together was 32.37 mm. The distance from the bone spicule to the medial epicondyle was 65.29 mm. In pathological cases, vascular disturbances, sensory deficits, and decreased muscle strength can be observed. A comprehensive description of this variation is crucial for enhancing current knowledge and awareness in clinical practice, as it aids in accurate diagnosis and treatment.</span></p> José Aderval Aragão Marcelo Lucas de Lima Prado Iapunira Catarina Sant’Anna Aragão Felipe Matheus Sant’Anna Aragão Francisco Prado Reis Deise Maria Furtado de Mendonça Copyright (c) 2024 Brazilian Journal of Case Reports 2024-03-28 2024-03-28 4 4 50 56 10.52600/2763-583X.bjcr.2024.4.4.50-56 Fetal Dilated Myocardiopathy – Case Report: Association with a heterozygous mutation in MYH7 gene <p>We report a case of dilated myocardiopathy with ascites and cardiac dysfunction detected at 20 weeks’ gestation. Baby was born at 33 weeks and 6 days, weighing 2530g, delivered by cesarean section and admitted to NICU. Postnatal echocardiography confirmed biventricular severe dysfunction, need of ventilatory support, vasoactive drugs, and prostaglandins. He was investigated for metabolic, infectious, and viral diseases with no positive results. After 6 weeks, he was transferred to a transplant center. Exome sequence showed a heterozygous mutation in the <em>MYH7</em> gene (OMIN-160760.0028).</p> Danielle Negri de Souza Lopes Fernanda Saraiva Bueno Marcia Cristina de Azevedo Gomes Sergio Ramos Fernando Freitas Martins Cassio Luiz de Carvalho Serão Maria Elisabeth Lopes Moreira José Maria de Andrade Lopes Copyright (c) 2024 Brazilian Journal of Case Reports 2024-04-01 2024-04-01 4 4 57 60 10.52600/2763-583X.bjcr.2024.4.4.57-60 Bell's palsy in a seven-month-old twin infant: a case report <p class="MDPI17abstract"><span lang="EN-US" style="color: windowtext;">Idiopathic peripheral facial paralysis is a rare condition in the pediatric population under one year of age, characterized by paralysis of the structures innervated by the facial nerve. This report describes the first infant in Brazil to be diagnosed with this clinical condition. A 7-months-old twin infant presented with altered left oromotor control and a discrete incomplete closure of the left eyelid when blinking, although with normal tear production. Her primitive reflexes were present and the spontaneous movements of the four limbs were normal. An investigation for infectious etiology and a magnetic resonance imaging of the brain were performed and did not show any alterations. Thus, the diagnosis of Bell's palsy was assumed, and oral prednisone was prescribed for five days. The patient evolved with total resolution of the facial paralysis during the first two weeks after discharge. Most cases of peripheral facial paralysis in children are idiopathic, while the others are associated with infectious and/or traumatic etiologies. There are still no consistent data proving the benefit of the use of corticoid alone or in combination with antiviral drugs for the treatment of children under one year of age.</span></p> Ádonis Pereira de Melo João Batista Siqueira de Albuquerque Neto Maria Fernanda de Lima Veloso Rafaella de Lima Lopes João Guilherme Bezerra Alves Copyright (c) 2024 Brazilian Journal of Case Reports 2024-04-01 2024-04-01 4 4 61 64 10.52600/2763-583X.bjcr.2024.4.4.61-64 Recurrent and multidrug-resistant suppurative mesenteric lymphadenitis in a dog <p class="MDPI17abstract"><span lang="EN-US" style="color: windowtext;">Suppurative mesenteric lymphadenitis is rarely described in veterinary medicine and is usually associated with other gastrointestinal or urinary tract diseases, immunosuppression, and infectious diseases. The aim of this study was to report a case of recurrent suppurative mesenteric lymphadenitis caused by coagulase-positive Staphylococcus in a 3-year-old female Shih Tzu dog, highlighting the importance of performing bacterial culture and antibiotic susceptibility testing for disease resolution. The animal was attended at the private Veterinary Hospital, in Vila Velha city, Espírito Santo, presenting clinical signs of abdominal pain in the hypogastric region, apathy, anorexia, and oligodipsia, along with a history of fever one day before and two similar episodes that were resolved with antimicrobial use. The patient had enlarged mesenteric lymph nodes and laboratory abnormalities consistent with an infectious process. Bacterial culture, following fine needle aspiration biopsy of the lymph nodes guided by ultrasound, identified the agent, and antibiotic susceptibility testing classified the bacterium as multidrug-resistant. The treatment instituted was meropenem combined with pain and fever control, leading to improvement of clinical signs, laboratory abnormalities, and disease remission. The patient did not experience recurrence, totaling 640 days of follow-up until the present time.</span></p> <p><span style="vertical-align: inherit;"> </span></p> Matheus Alexandre da Costa Alves Libarde Igor Luiz Salardani Senhorello Copyright (c) 2024 Brazilian Journal of Case Reports 2024-04-02 2024-04-02 4 4 65 72 10.52600/2763-583X.bjcr.2024.4.4.65-72 Isolated left ventricular non-compaction cardiomyopathy: case report and brief review on diagnostic imaging methods <p>Left ventricular non-compaction cardiomyopathy (LVNC) is a rare congenital heart disease with an estimated incidence of 0.014-0.045% in a general population. It occurs due to a morphogenetic abnormality during embryogenesis that inhibits myocardial compaction and determines prominent trabeculae with deep intertrabecular spaces and thickening of the adjacent myocardium in two distinct layers. Diagnosis is generally established via transthoracic echocardiogram (TTE) with further confirmation with cardiac magnetic resonance (CMR). A 57-year-old male patient previously diagnosed with systemic arterial hypertension and chronic obstructive pulmonary disease reported chest pain and dyspnea upon exertion, headache, and dizziness. During outpatient investigation, the patient was submitted to a stress electrocardiogram that was positive for ischemia and led to a cineangiocoronariography with no signs of coronary artery obstruction. At the echocardiography lab, several trabeculations were detected in the apical region of the left ventricle. A diagnosis of LVNC was established and the results were confirmed via CMR. Management was initiated with the goal of symptom relief. LVNC is a relatively unknown pathology that is frequently underdiagnosed at earlier stages. As presented, we highlight the importance of multimodality imaging, especially TTE and CMR, in the diagnosis of this congenital heart condition.</p> José Victor da Nóbrega Borges Samira Abdel Correia Leila Manuella Guedes da Nóbrega Machado Copyright (c) 2024 Brazilian Journal of Case Reports 2024-04-13 2024-04-13 4 4 73 77 10.52600/2763-583X.bjcr.2024.4.4.73-77 Challenges in the Surgical Management of Large Osteoma in the Maxillary Sinus: Case Report <p>Osteoma is a benign neoplasm characterized by slow growth and can be composed of spongy or compact bone. Its symptomatology is directly related to the location, size, and proximity to adjacent structures. Histologically, it is classified as compact, cancellous, or mixed. Although rarely found in the gnathic bones, they are more frequently observed in the paranasal sinuses. This study aims to report a case of osteoma located in the maxillary sinus of a male patient, describing the surgical management performed in a hospital setting. The patient, a 49-year-old male with no systemic diseases, underwent surgical procedure under general anesthesia, including intraoral access, excision of the lesion, and subsequent fixation of the bone fragment. After six months of postoperative follow-up, no recurrences were observed. It is concluded that the definitive treatment of osteoma requires adequate correlation of the clinical picture, selection of the best type of surgical access, consideration of the location, and choice of the most appropriate synthesis method to promote a good prognosis.</p> Radamés Bezerra Melo Sara Rodrigues Azevedo Luiz Henrique Ferreira Freitas Raissa Pinheiro Moraes Jonas Nogueira Ferreira Maciel Gusmão Copyright (c) 2024 Brazilian Journal of Case Reports 2024-04-26 2024-04-26 4 4 78 83 10.52600/2763-583X.bjcr.2024.4.4.78-83 Adenocarcinoma em pouch gástrico após 10 anos de bypass gástrico em Y-de-Roux: um relato de caso <p>A obesidade é uma doença de alta e crescente prevalência em todo o mundo. O tratamento cirúrgico através do<em> bypass</em> gástrico em Y-de-Roux (BGYR) é eficiente e duradouro no tratamento do excesso de peso e suas comorbidades associadas, auxiliando inclusive, na redução de incidência de neoplasias. Apesar disso, há raros casos na literatura de pacientes pós-cirurgia bariátrica com câncer esôfago-gástrico. A definição dos mecanismos associados a essas duas patologias é incerta, sendo recentemente um objeto de estudo. Neste artigo, realizamos uma revisão de literatura a respeito deste assunto e descrevemos o caso de uma paciente submetida a BGYR que, após 10 anos da cirurgia, desenvolveu adenocarcinoma no <em>pouch</em> gástrico.</p> Taiana Naila Mazaro Zarelli Paula Heroso Moreira Fernanda Biasi da Cunha Ana Luisa Schoeler Solange dos Anjos Martins Cravo Fruet Bettini Fabio Terabe Copyright (c) 2024 Brazilian Journal of Case Reports 2024-05-03 2024-05-03 4 4 84 88 10.52600/2763-583X.bjcr.2024.4.4.84-88 Cistite folicular: relato de caso e revisão de literatura <h4><span style="font-weight: 400;">A cistite folicular é uma patologia proliferativa benigna com padrão histológico patognomônico. Acomete principalmente mulheres e relaciona-se com exposição a possíveis agentes agressores com sintomas inespecíficos. Apresenta-se o caso de uma paciente do sexo feminino, latino-americana, 68 anos, ex-tabagista, hipertensa há 15 anos e portadora de diabetes mellitus tipo 2 há 28 anos com antecedente clínico de 3 episódios agudos de litíase renal, o primeiro há 15 anos, além de infecções urinárias de repetição. A paciente apresentava hematúria há 1 mês, além de nictúria, relatando aumento da frequência e redução do volume miccional. O diagnóstico da patologia se deu por meio da cistoscopia com biópsia vesical, que demonstrou a presença de folículos linfóides ativados na lâmina própria, subjacentes a urotélio inflamado e sem atipias. A cistite folicular é uma doença extremamente rara, muito pouco descrita na literatura nacional e internacional e não possui campos de pesquisa relevantes até o momento. Sendo assim, demonstramos aqui a importância da investigação clínica em conjunto com a análise histológica da biópsia vesical, fundamentais para o diagnóstico e tratamento adequado da cistite folicular.</span></h4> Gabriela Canali Locatelli Bellini Nicole Santini Jorge Alberto Menegasso Aline Caldart Tregnago Copyright (c) 2024 Brazilian Journal of Case Reports 2024-05-06 2024-05-06 4 4 89 94 10.52600/2763-583X.bjcr.2024.4.4.89-94 Inserção de cateter de Shilley para manejo de grande abscesso do músculo psoas em mulher jovem: relato de caso <p><span style="font-weight: 400;">O abscesso de músculo psoas é uma patologia não muito frequente, que está relacionada a uma infecção primária ou secundária que ocasiona a formação de coleção purulenta na anatomia do músculo psoas que pode ocasionar inúmeras consequências. Este trabalho apresenta um caso raro para literatura, analisando a fisiopatologia, diagnóstico e tratamento, dando enfoque no acometimento de paciente do sexo feminino e jovem, além da utilização de Cateter de Shilley para manejo e sua eficácia no caso.</span></p> Luis Eduardo Sepulveda Mesquita Gabriely Lorrany de Oliveira Silva Beatriz Ribeiro Carneiro Bruno Henrique Campos Afonso Luis Flávio Vilela de Mesquita Copyright (c) 2024 Brazilian Journal of Case Reports 2024-05-07 2024-05-07 4 4 95 100 10.52600/2763-583X.bjcr.2024.4.4.95-100 A transmuscular path of the medial branch of the high division of the median nerve: an anatomical variation of clinical and surgical importance <p><span style="vertical-align: inherit;"><span style="vertical-align: inherit;">The median nerve (MN) is a mixed nerve formed in the brachial plexus, which innervates a large part of the upper limb. It presents several variations in its trajectory, resulting in many pathologies and iatrogenic surgical compromises. This report highlights a transmuscular route of the medial branch of the upper division of the MN, which to date does not fit into the classifications described in the literature on MN variations. Knowledge of this high division of the MN, as well as its transfixation by the flexor digitorum superficialis muscle, is of fundamental importance in neuropathy syndromes due to entrapment of the MN, as well as in surgical guidance to prevent injuries. Late diagnosis of traumatic peripheral nerve injuries results in greater functional impairment and greater socioeconomic loss, especially in young patients. Therefore, timely identification is essential to minimize long-term consequences and improve the patient's quality of life.</span></span></p> Caio Siqueira Kuhn Lucimário de Carvalho Barros Iapunira Catarina Sant’Anna Aragão Felipe Matheus Sant’Anna Aragão Francisco Prado Reis Deise Maria Furtado de Mendonça José Aderval Aragão Copyright (c) 2024 Brazilian Journal of Case Reports 2024-05-09 2024-05-09 4 4 101 108 10.52600/2763-583X.bjcr.2024.4.4.101-108 Chronic secondary orofacial pain as the first symptom of chronic non-bacterial osteomyelitis in the mandible: a case report and literature review <p>Chronic non-bacterial osteomyelitis clinically manifests with pain, swelling and limitation of movement. When it affects the jaws, it can cause pain, similar to other orofacial conditions, requiring a correct differential diagnosis. The objective of this study was to report a clinical case of chronic secondary orofacial pain as the first manifestation of an inflammatory bone disease located in the mandible, in addition to discussing the diagnostic hypotheses, the pathophysiological aspects and the therapy. A 21-year-old male patient came to the service complaining of pain in the mandible, preauricular and temporal regions bilaterally with one year of evolution, associated with anterior open bite and psychological impairment. So, it was chronic orofacial pain secondary to non-bacterial osteomyelitis with a high rate of bone remodeling. Elevation of pro-inflammatory cytokines can lead to an increased power cycle of nociceptive signaling, chronic inflammation, and bone loss. Pro-inflammatory cytokines that originate in neuronal and glial cells can trigger effects such as chronic hyperexcitability, changes in the phenotypic expression of nociceptors and abnormal processing of noxious signals. The patient is still undergoing treatment and without pain. Careful assessment, ordering tests and multidisciplinary investigation are essential in the care of patients with chronic and complex orofacial pain.</p> Samilla Pontes Braga Raniel Ramon Norte Neves Sumatra Melo da Costa Pereira Jales André Caroli Rocha Rosa Maria Rodrigues Pereira José Tadeu Tesseroli de Siqueira Copyright (c) 2024 Brazilian Journal of Case Reports 2024-05-11 2024-05-11 4 4 109 117 10.52600/2763-583X.bjcr.2024.4.4.109-117 Laserterapia para tratamento de Queimadura química em âmbito hospitalar: relato de caso <p>Queimaduras em mucosa oral, especialmente língua, palato e lábios, podem resultar de traumas térmicos, químicos ou elétricos. Este artigo destaca as queimaduras químicas, originadas por substâncias ácidas ou alcalinas, ressaltando a gravidade dessas lesões e as limitações dos protocolos de atendimento existentes, frequentemente baseados em queimaduras térmicas. O estudo visa validar a hipótese de que a laserterapia de baixa potência, em conjunto com a terapia fotodinâmica, é eficaz no tratamento de queimaduras químicas em mucosa oral. Explorando as propriedades únicas da laserterapia, busca-se acelerar a regeneração celular, aliviar a dor e promover a cicatrização, contribuindo para reduzir o tempo de internação hospitalar, minimizar susceptibilidades a infecções e melhorar a qualidade de vida dos pacientes. Com base nos resultados obtidos, o estudo sugere que a laserterapia de baixa potência e a terapia fotodinâmica são promissoras no tratamento de queimaduras químicas em mucosa oral. Além de acelerar o processo de cicatrização, essas abordagens oferecem alívio da dor e estimulam a regeneração celular. No entanto, destaca-se a necessidade de estudos epidemiológicos e protocolos de atendimento específicos para otimizar estratégias preventivas e terapêuticas, visando uma abordagem mais efetiva e personalizada para esse tipo de lesão.</p> Iago Vidal Bárbara Gressy Duarte Souza Carneiro Marcelo Leite Machado da Silveira Maria Joceleide Jorge Ariel Valente Bezerra Copyright (c) 2024 Brazilian Journal of Case Reports 2024-05-23 2024-05-23 4 4 126 133 10.52600/2763-583X.bjcr.2024.4.4.126-133 Acute Tuberculous Appendicitis, a Rare Entity <p>Tuberculous appendicitis is a rare disease, with an overall incidence of between 1.5-3.0% among tuberculosis patients. It was first described by Corbin et al in 1873 and since then has been rarely recorded in publications and case reports. In the USA, extrapulmonary disease is seen in around 20-30% of tuberculosis patients, with the most common extrapulmonary manifestations being bone (30%), urinary tract (24%) and lymph node (13%) involvement. A high index of suspicion is required to make the diagnosis of appendicular tuberculosis, although it can cause damage to the appendix without other signs of localized disease. We report a case of a woman diagnosed with primary tuberculous appendicitis in a patient with human immunodeficiency virus (HIV), with evidence of extra-intestinal disease.</p> João Kleber de Almeida Gentile Beatriz Terezinha Franco Renesto Luis Fernando Alves Miléo André Cosme Oliveira Sérgio Henrique Couto Horta Flávia Magella Ronaldo Modesto de Souza-Filho Copyright (c) 2024 Brazilian Journal of Case Reports 2024-05-28 2024-05-28 4 4 134 140 10.52600/2763-583X.bjcr.2024.4.4.134-140 Multiple Wormian Bones in the Lambdoid Suture: A Report of Rare Occurrence <p><span style="vertical-align: inherit;"><span style="vertical-align: inherit;">Wormian bones are irregular bony structures developed from independent ossification centers located at the junction of the sutures between the cranial bones. Although they are commonly found in healthy individuals, their presence can be associated with pathological conditions. Their number above 10, large size, or mosaic pattern are clinically considered as indicators of several pathological conditions, such as abnormalities in the central nervous system, musculoskeletal system, or metabolic changes throughout the body. Our study aims to report a rare occurrence of 40 Wormian bones found in the lambdoid suture of an adult human skull and provide a literature review. Understanding the presence of Wormian bones is crucial for professionals such as neuroanatomists, neurosurgeons, radiologists, anthropologists, and morphologists, as they may be mistaken for fractures in cases of traumatic brain injury.</span></span></p> José Aderval Aragão Roberto Ferreira de Oliveira Smilly Oliveira de Sousa Silva Lucas Inacio Riffel Iapunira Catarina Sant’Anna Aragão Felipe Matheus Sant’Anna Aragão Giulianna da Rocha Borges Francisco Prado Reis Deise Maria Furtado de Mendonça Copyright (c) 2024 Brazilian Journal of Case Reports 2024-06-06 2024-06-06 4 4 141 149 10.52600/2763-583X.bjcr.2024.4.4.141-149