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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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Critical role of feedback in clinical reasoning. (A) Feedback reinforces decisions that lead to correct diagnoses and (B) allows for recalibration when necessary. (C) In the absence of feedback, clinicians may continue inappropriately on a default pathway.

Anchor’s Away: A Case of Apparent Sinusitis

Diagnostic errors, defined as failures to reach timely and accurate explanations for a patient’s presentation, affect the majority of our patients, because most will experience at least one diagnostic error in their lifetime.1 We report the case of a patient who was inappropriately diagnosed with acute bacterial rhinosinusitis and later found to have lymphoma. We use […]

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(A) Aphthous ulcer of the uvula (arrow). (B) Healed uvula.

The Wrong Toothpaste and the Painful Burp

  Recurrent aphthous stomatitis is usually confined to the buccal mucosa, lips, and tongue. Rarely, the uvula may be involved. Although the disease is considered idiopathic, recurrences may be associated with the use of sodium lauryl sulfate-containing oral hygiene products. Objective To report a case of an aphthous ulcer located on the uvula, with an […]

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