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The Complexities of Iron Deficiency in Patients After Bariatric Surgery

  To the Editor: Iron deficiency is one of the most common micronutrient deficiencies after bariatric surgery and is often overlooked by healthcare providers when patients present with vague symptoms or laboratory results do not demonstrate straightforward iron-deficiency anemia. Thus, it is imperative that providers order tests and interpret laboratory results carefully so they can […]

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Cough Syncope

Although cough is a common clinical symptom, the vasomotor effects on the heart and systemic circulation are often underappreciated. A healthy 42-year-old man without significant medical history presented with repetitive episodes of syncope during coughing. His examination, electrocardiogram, laboratory studies, and echocardiography results were normal, and carotid massage did not provoke any adverse response. During […]

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(A) Left temporal cutaneous lesion prior to immunotherapy. (B) Left temporal cutaneous lesion after 7 cycles of immunotherapy.

Immunotherapy in Squamous Cell Skin Carcinoma: A Game Changer?

  A 74-year-old white male was diagnosed with squamous cell carcinoma in 2013. Six months after Mohs surgery, he underwent a left superficial parotidectomy, left neck dissection, and excision of the left postauricular lymph node after confirmation of lymphatic spread. Pathology from the left parietal scalp lesion revealed multifocal invasive squamous cell carcinoma. Extranodal tumor […]

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elder woman in eye exam

Eyes Are Useless When the Mind Is Blind: Anton-Babinski Syndrome

Anton-Babinski syndrome is a condition in which patients deny vision loss despite objective evidence. They further confabulate to support their stance. Cortical blindness is the loss of vision caused by a unilateral or bilateral lesion in the occipital cortex in the presence of normal anterior visual pathway. Anton syndrome is most commonly due to bilateral […]

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A, The mass in the proximity of the left atrium in the 4-chamber view on TTE (white arrow). B, The mass in the proximity of the left atrium on TEE (white arrow). C, Four-chamber view. T2-weighted magnetic resonance imaging demonstrates homogeneous increased T2 signal intensity of the mass (white arrow). D, Four-chamber postcontrast T1 fat-saturated image demonstrates significant homogeneous enhancement of the mass (white arrow). E, Positron emission tomography image showing significant diffuse homogeneous 18F-fluoro-2-deoxy-D-glucose uptake throughout the mass. F, 10× hematoxylin–eosin stain of the tumor; tumor cells are in a nested growth pattern and separated by pink sclerotic collagenous stroma with well-vascularized lesion. G, 10× chromogranin immunohistochemical stain. H, 10× synaptophysin immunohistochemical stain.

An Incidentaloma in the Cardiology Clinic

  Paragangliomas are rare neuroendocrine tumors of neural crest origin.1, 2 In this report, we describe the exhaustive diagnostic workup involved in the diagnosis of a paraganglioma, which was first noted as an incidental mass in the proximity of left atrium on a routine transthoracic echocardiogram (TTE). Case Report A 55-year-old man with a history of valvular […]

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Panel A: skin erosion without penetrating wound on the postero-medial face of the left elbow. Panel B: bony bruise of the medial condyle (white arrow), hypersignal of the ulnar nerve on T2-weighted MRI scan (open arrow).

Bataclan’s Ulnar Nerve Syndrome

On November 13, 2015, during terrorist attacks in the Bataclan concert room (Paris, France), a 24-year-old man with no medical past history (except for thrombocytopenic purpura in childhood) was injured by gunshots on the left elbow. After having escaped, he was taken in charge by prehospital units and transferred to the emergency department of a […]

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