Left Forearm Swelling Research Articles

Ulnar Artery Pseudo-Aneurysm in a Young Adult Male Due to Penetrating Trauma

Introduction: We present a young adult male who developed a proximal left ulnar artery pseudo-aneurysm that resulted from a penetrating stab wound after a period of 10years. Case Presentation: A 28years old male was referred to our facility with a history of an expanding left forearm swelling. He was initially diagnosed as a case of haematoma. A clinical diagnosis of pseudoaneurysm was confirmed by computed tomography angiography and resection done with ligation of the proximal ulnar artery and the distal branches. Conclusion: Proximal ulnar artery pseudo-aneurysm is very rare and may be associated with dire consequences in cases of delayed or missed diagnosis. Operative intervention remains the mainstay of treatment.

Man with left forearm swelling, paresthesia, and dullness of sensation.

Man with left forearm swelling, paresthesia, and dullness of sensation.

Extradigital glomus tumor of left forearm: An unusual cause for persistent forearm pain

Glomus tumors are rare, benign, and vascular neoplasm of the glomus body, accounting <2% of all soft tissue tumors. The most common site is the subungual region of the fingers and toes. Extradigital sites, including the forearm, are uncommon and usually misdiagnosed because of their rarity and nonspecific presentation. Diagnosis is often delayed due to low level of suspicion. A strong clinical suspicion, magnetic resonance imaging, and a properly planned surgery remain the treatment. We report a 70-year-old male presented with a very small painful left forearm swelling for the last 20 years who had undergone surgical excision.

Peripheral soft tissue Ewing’s sarcoma: a rare case report

A 22 years male patient presented with gradual left forearm swelling for 6 months. X ray forearm revealed large soft tissue swelling with tiny calcification and mild scalloping at inner aspect of ulna and ultrasonogram (USG) revealed soft tissue mass having calcification and necrotic areas within and spectral Doppler showed arterial type of blood flow with no augmentation. Later computerized tomography (CT) scan showed soft tissue mass with necrotic area and calcification with no bony involvement. Magnetic resonance imaging (MRI) with contrast revealed a large heterogeneously enhancing lobulated mixed intensity lesion in antero-medial compartment of the left forearm involving flexor group of muscles causing displacement of fat plane. MRI and subsequent histopathology of the lesion revealed it as a rare soft tissue Ewing’s sarcoma / primitive neuroectodermal tumor (PNET) in extremity. DOI: http://dx.doi.org/10.3329/imcj.v7i2.20113 Ibrahim Med. Coll. J. 2013; 7(2): 43-46

Proliferative myositis: A case report and review of literature

Proliferative myositis is a benign, reactive, pseudosarcomatous fibroblastic proliferation associated with bizarre giant cells resembling ganglion cells. It is most commonly seen in 5 th decade of life. It is a skeletal muscle counterpart of proliferative fasciitis, which clinically and histologically resembles it. It most commonly affects skeletal muscles of shoulder, thorax, and thigh. Trauma is considered to be most common etiological factor. Grossly, it presents as a discrete solitary nodular mass with irregular margins measuring 1-6 cm in size. Histopathological examination of tissue shows sheets of myofibroblasts amixed with large cells, which resemble ganglion cells. Immunohistochemical evaluation of the tissue shows positivity for vimentin and SMA and negativity for desmin in myofibroblasts, whereas ganglion cell-like cells are focally positive for SMA. We report a case of proliferative myositis in a 42-years-old female patient who presented with a slow-growing, painless, irregular swelling in left forearm 3 cm below the elbow.

Pleomorphic hyalinizing angiectatic tumor of soft parts involving the upper limb

Pleomorphic hyalinizing angiectatic tumor (PHAT) of soft parts is a low grade, rare, soft tissue tumor which commonly occurs on the lower extremities of adults of either sex, though lesions in other anatomic locations have been described. We present a case of a 65-year-old female patient who presented with a left forearm swelling and underwent a wide local excision. Histopathology revealed it to be a PHAT.

Acquired factor VIII deficiency after consuming the dried gallbladder of a cobra,Naja naja

Acquired factor VIII deficiency is very rare, often fatal. It is associated with pregnancy, autoimmune diseases, malignancy, and drugs, although no underlying cause is found in 50%. A 49-year-old male was referred with right shoulder bruising. The coagulation test showed a prolonged activated partial thromboplastin time. The factor VIII level was less than 1%, and the factor VIII inhibitor antibody titer was 246 Bethesda units/mL. The findings were compatible with acquired factor VIII deficiency. He had consumed the dried gallbladder of a cobra, Naja naja, for two weeks, it contained venom. After the initial treatment with factor VIII, he did not take supplemental coagulation factor VIII. The patient was readmitted with left forearm swelling. He lost consciousness suddenly and brain computed tomography (CT) revealed a subdural hematoma. Despite administering recombinant factor VII, his bleeding was not controlled and he died.

A Girl with Severe Hand Swelling and Abdominal Cramps

A 16-year-old girl presented to the emergency room with severe swelling of her left hand and forearm. Her symptoms began 12 h earlier with left forearm swelling that progressed to the tips of her fingers. She reported her forearm felt normal, but her hand had a tingling sensation and she was barely able to move her fingers. She also reported having had moderately painful abdominal cramps earlier that day. She denied urticarial or pruritic rashes, respiratory distress, and throat tightness. During the previous week she had felt stressed because of schoolwork and also had developed a mild headache, clear rhinorrhea, and cough. She had never had episodes of swelling in the past. Family history revealed similar episodes in multiple family members. The patient’s father and 15-year-old sister had histories of numerous episodes of painful localized edema since childhood. Her paternal grandmother, great-grandfather, and great-great-grandfather died of asphyxiation due to attacks of angioedema and swelling of the throat. Her mother and 13-year-old brother were healthy. On examination, the patient appeared well and in no respiratory distress. Vital signs were stable. Her skin had no rashes. Her left upper extremity was severely swollen from the midforearm to the fingertips. Her left hand was cold and capillary refill was mildly delayed. The patient reported a tingling sensation when her fingers were superficially palpated. Flexion and extension of her fingers were greatly reduced. The patient’s abdomen was soft but diffusely tender, without hepatosplenomegaly. There was no swelling of other body parts. Physical examination results were otherwise unremarkable. Complete blood count showed mild leukocytosis with neutrophilic predominance. C-reactive protein was 15 mg/L (reference interval <5 mg/L), C3 was 1170 mg/L (reference interval 830–1770 mg/L), and C4 was <60 mg/L (reference interval 140–420 mg/L). Angioedema in a patient with positive family history and low C4 is …

A Case of Saccular Arteriosclerotic Aortic Aneurysm Associated with Thrombus in Aortic Arch

An aortic aneurysm is described as a permanent localized dilatation of the aorta having a diameter at least 1.5 times that of the expected normal diameter of that given aortic segment. Thoracic aortic aneurysms are much less common than are aneurysms of the abdominal aorta. Thoracic aneurysms are classified by the portion of aorta involved, i.e., the ascending, arch, or descending thoracic aorta. We experienced a case of saccular arteriosclerotic aortic aneurysm associated with thrombus in aortic arch in a 78 year-old male who had history of hypertension. He was admitted to Kwangju Veterans Hospital complaining of drowsy mental state and swelling of left forearm. The chest X-ray, chest CT and echocardiogram showed saccular dilatation(maximal diameter; 7.67–7.86cm) associated with thrombus in aortic arch. He refused operation because of old age, so he was conservatively managed including propranolol. We report this case of saccular arteriosclerotic aneurysm of aortic arch with a brief review of literature.