The role of detailed medical history for the early diagnosis of familial bradycardia in a patient with associated atrial fibrillation: case report.

Background: Bradycardia represents a frequent reason for medical presentation and has a complex aetiology, including genetic disorders, like LMNA mutation. LMNA mutation is responsible for laminopathies, including LMNA -cardiomyopathy. Cardiac involvement is prevalent and is linked to dilated cardiomyopathy associated with conduction block, which is anticipated by bradyarrhythmia and supraventricular tachyarrhythmia.

An unusual shaped mass filling the right cardiac chambers in a woman with a vascular malformation.

We present an interesting case of a patient with uterine leiomyoma and a vascular abnormality of the internal iliac artery and peri‑uterine veins presenting a right intracardiac mass with an extremely unusual and misleading shape, requiring surgical removal and pathological examination to confirm the diagnosis.

Achenbach Syndrome - Case Report and Discussion on the Interdisciplinary Approach of a Patient.

We present a case of Achenbach syndrome, which is an alarming disease for both patients and physicians, although it is a rare, benign and self-limiting disorder. It is also reported as "paroxysmal finger haematoma", but the majority of cases are misdiagnosed, and unnecessarily investigated and treated.

Milia en Plaque of the Earlobe.

Milia en plaque is an uncommon benign dermatosis. We present a case of a 43-year-old Caucasian man with a five-month history of asymptomatic symmetric lesions on the earlobes that has been previously treated by self-medication with potent topical steroids, emollients, cosmetic procedures, herbal medication and punch-procedure. Based on clinical examination, a diagnosis of milia on earlobes was established and treated with topical steroids.

Primary angiosarcoma of the vulva: report of a case misdiagnosed as a benign tumor.

Primary vulvar angiosarcomas have a propensity for varied macroscopic and histologic appearance that initially may not suggest a vascular malignant neoplasm. Therefore, the rarity of the lesion and it's morphologic diversity may contribute to the high rate of misdiagnosis. We present the case of a 43-year old patient with a primary vulvar lesion, initially misdiagnosed as an angiofibroma.

Extensive Left Ventricular Thrombosis with Concomitant Pulmonary Embolism.

A 57-year-old non-obese female patient with a history of heavy smoking, chronic obstructive pulmonary disease and hypertension was admitted to the hospital as an emergency for acute hemoptysis and signs of congestive heart failure. To assess the source of hemoptysis, computed tomography (CT) pulmonary angiography was performed, which confirmed a bilateral pulmonary embolism of the apical branches. The routinely performed transthoracic echocardiography (TTE) revealed an enlarged left ventricle with severely reduced ejection fraction (EF = 25%) due to global hypokinesia and multiple, mobile, echogenic masses.

Endometrial adenocarcinoma with gastrointestinal differentiation - a newly described entity, with morphologic diversity.

Gastrointestinal type of endometrial carcinoma is a newly described entity for which clearly defined diagnostic criteria have only recently been published. Among morphologic criteria, gastrointestinal mucinous adenocarcinoma of endometrium must not show a typical endometrioid component. We present a case with morphologic diversity, with areas showing gastric and intestinal differentiation as well as an endometrioid-like component.

Primary extrauterine cystic low-grade endometrioid stromal sarcoma mimicking stromal endometriosis. A case report emphasizing the differential diagnosis and its potential local aggressive behavior.

Genital and pelvic endometriosis is a frequently encountered lesion and its importance rely on associated symptoms and its propensity for malignant transformation. In the present paper we comment on the importance of correctly diagnose the malignant transformation of an endometriotic lesion into a cystic low-grade endometrial stromal sarcoma, which is a very rare event. Moreover, we discuss the ability of a low-grade endometrial stromal sarcoma to locally recurr and the differential diagnosis with stromal endometriosis, a lesion that is very rare, almost always microscopic and solid.

Analysis of Clinical-Pathological Data with Impact on Overall Survival in Male Breast Carcinoma: An International Multi-Institutional Study of 217 Cases.

The aim of this study was to evaluate clinical-pathological parameters with impact on overall survival (OS) in male breast carcinoma (MBC). Methodology: We assessed OS at 5 years and at 10 years respectively, as well as OS according to age, tumor size, microscopic type, histological grade, axillary lymph node status, and molecular profile. Two hundred seventeen cases, with a mean age of 62 (range: 18- 85), right breast involvement (52.

Can Morphological and Molecular Parameters of the Primary Breast Tumor Predict the Positivity of Nonsentinel Lymph Nodes After Positive Sentinel Lymph Node Biopsy?

Sentinel lymph node (SLN) biopsy is the gold standard in the evaluation of the axillary status in patients with breast cancer. In cases meeting the Z0011 criteria, no further surgery is needed, while in the remaining cases axillary dissection is required. The aim of the study was to evaluate which morphological and molecular parameters of primary breast tumor or positive SLN can predict the positivity of nonsentinel lymph nodes (NSLN) in order to avoid unnecessary axillary lymphadenectomy.

The Accuracy of the Preoperative Axillary Ultrasound Examination in Predicting the Status of the Sentinel Lymph Node Involvement in Patients with Infiltrating Breast Carcinoma.

we aimed to determine the accuracy of preoperative axillary ultrasound (US) in predicting the presence of sentinel lymph node (SLN) metastasis in breast cancer patients. Methods and out of 54 cases, visible nodes on US were identified in 35 cases of which, 15 had metastasis. In 19 cases no axillary lymph nodes were visible on US.

Sacral (S1) herpes zoster.

Herpes zoster usually affects the thoracic and lumbar vertebra (T3-L3), while sacral herpes zoster has been very rarely reported. We present a very rare case of herpes zoster involving S1 dermatome in a 35-year-old healthy man who presented aching pain and typical herpes zoster eruption on the lateral aspect of the calcaneus, lateral plantar area and dorsal aspect of digits III and IV.

Novel Therapeutic Options in the Management of Reflex Syncope.

Background: Syncope is a symptom associated with a wide range of pathological conditions, ranging from benign to life threatening. The most frequent is the reflex syncope that may be challenging to treat because of the complex and partially unknown pathophysiological mechanism that has to be addressed by the chosen therapy.

Areas Of Uncertainty: Head-up tilt testing is so far the only clinical test able to reproduce reflex syncope, but its diagnostic yield has been recently redefined.

MASked-unconTrolled hypERtension management based on office BP or on ambulatory blood pressure measurement (MASTER) Study: a randomised controlled trial protocol.

Introduction: Masked uncontrolled hypertension (MUCH) carries an increased risk of cardiovascular (CV) complications and can be identified through combined use of office (O) and ambulatory (A) blood pressure (BP) monitoring (M) in treated patients. However, it is still debated whether the information carried by ABPM should be considered for MUCH management. Aim of the MASked-unconTrolled hypERtension management based on OBP or on ambulatory blood pressure measurement (MASTER) Study is to assess the impact on outcome of MUCH management based on OBPM or ABPM.

ER-/PR+ subset of invasive breast carcinoma (IBC): a distinct phenotype with good prognosis.

The expression of the estrogen (ER) and progesterone (PR) receptors in IBC patients represents a well-know prognostic and predictive factor. The existence of ER-/PR+ as a distinct phenotype, however, is controversial as well as is its prognostic significance. The aim of the study was to assess the incidence and prognosis in patients with ER-/PR+ IBC.

Encapsulated papillary breast carcinoma in a male patient in association with microdeposits of carcinoma cells in the needle track and sentinel lymph node treated conservatively.

We present an encapsulated papillary breast carcinoma in a male patient, in association with microdeposits of carcinoma cells within the needle track, in the lymphatic spaces of the breast parenchyma and subcapsular sinus of two sentinel lymph nodes in which conservative treatment has been recommended. Both in females and males, papillary tumours and particularly encapsulated papillary breast carcinoma can be associated with microdeposits mechanically displaced, which have to be differentiated from true invasion and metastases and treated conservatively.

Keloidal-like local recurrence after infiltrating adenosquamous breast carcinoma with stromal-overgrowth mimicking a benign skin lesion.

We present a very rare case of an adenosquamous infiltrating breast carcinoma with sarcomatous stromal overgrowth of hypocellular collagenised type, which subsequently developed local recurrence, mistaken for a benign skin lesion due to bland keloid-like morphological appearance. All the histological, immunohistochemical, and clinical features must be taken into consideration when distinguishing between a benign skin lesion and a local recurrence of a rare subtype of breast carcinoma.

Transient yellow discoloration of the nails for differential diagnosis with yellow nail syndrome.

A differential diagnosis must be made between transient yellow discoloration of the nails and yellow nail syndrome. We highlight some practical aspects of yellow nail discoloration.