Case Report

CASE PRESENTATION
A 66-year-old male had a routine physical examination. He had a moderately enlarged benign prostate gland. The prostate-specific antigen (PSA) was 7.7, and the ratio of free/total PSA was 9% (normal > 25%). A prostate biopsy revealed multiple cores of adenocarcinoma of the prostate, Gleason score 3 + 4. He was treated with I-125 brachytherapy plus 20 Gy of external beam therapy to the periprostatic tissue, and the PSA nadir was 0.7 ng/mL 6 months after the radiation therapy. However, 6 months later the PSA increased to2.7, and repeat PSA testing demonstrated progr...

CASE PRESENTATION
A 63-year-old woman presented in June complaining of a 1-week history of malaise, headache, generalized body aches, and low-grade fever of 101 degrees F. She denied any upper respiratory, gastrointestinal, or other associated symptoms. Physical examination was generally unremarkable with the exception of a slightly raised, 8 x 6–cm, irregular, ovoid patch with spotty areas of mildly intense-to-faded erythema found on her right anterior thigh (Figure 1). A central papule was noted, consistent with a punctum from a recent tick or insect bite (Figure 2). When the lesi...

CASE PRESENTATION
A 70-year-old man was brought to the emergency room by his neighbor, who reported a 10-day history of progressive fatigue, leg pain, and generalized weakness. The patient had suffered an ischemic stroke 7 months before and was dependent on his neighbor for his daily care. His past medical history was significant for hypertension. His caretaker also commented on the patient’s decline in function during the last month, noting some “bloody stools,” shortness of breath, “easy bruising,” leg swelling, and a recent “red rash” on his arms and legs. The patient...

INTRODUCTION
Radiation-induced1,2 second primary malignant tumors include meningiomas, sarcomas, and gliomas. Patients who received prophylactic intracranial irradiation and intrathecal methotrexate for acute lymphocytic leukemia or lymphoma may occasionally also develop brain tumors. Such tumors consist mainly of glioma. Rarely, meningioma, meningeal melanocytoma, fibrosarcoma, and primitive neuroectodermal tumor have also been described.1,3 We report herein an interesting case of primary central nervous system (CNS) lymphoma developing 8 years after irradiation for ca

CASE PRESENTATION
A 75-year-old Haitian man presented to the emergency department (ED) with altered mental status (disoriented to time and place). Although a poor historian, he did report progressive worsening of vision in his eyes bilaterally over an approximate 2-week period. Past medical history included type 2 diabetes mellitus for approximately 6 years and hypertension. He was not compliant with medications for these chronic conditions as prescribed by his primary care physician and was taking no medications at the time of assessment in the ED. Social history was significant for ...

Iodine-induced hyperthyroidism, or Jod-Basedow phenomenon, a thyrotoxic condition caused by exposure to increased amounts of iodine, has historically been reported in regions deficient in iodine.1 However, with advances in contrast imaging, this hyperthyroidism has more recently been reported in patients following studies that require administration of iodine-containing contrast media,2-5 but has received little attention in the elderly,6,7 who frequently undergo such studies. The increasing application of these imaging techniques to evaluate and prognosticate diseases of advanced age, in c...

CASE PRESENTATION
An 86-year-old woman presented to the emergency department complaining of left-sided flank pain that had awoken her from sleep earlier that morning. She rated the pain severity as 6 on a scale of 1 to 10, with radiation to the left groin and no relief on position change. She had no hematuria, dysuria, fever, or chills. Past medical history included a stroke at age 83, with no residual deficits, hypertension, atrial fibrillation, depression, and pacemaker for sick sinus syndrome. Her medications were warfarin 5 mg daily, digoxin 0.25 mg daily, fosinopril 10 mg daily, ...