Browsing by Author "Pratka, Holden"
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Item Atypical Leiomyosarcomas of the Great Saphenous Vein and Subcutaneous Superficial Vein(2024-03-21) Pratka, Holden; Qadri, SyedTwo outpatient adult cases of primary leiomyosarcomas are reported in atypical locations. As a tumor of smooth muscle origin, leiomyosarcomas are most frequently found in the uterus, intestines, and other parts of the digestive tract (Rizwan et al., 2020). Here, we highlight and discuss two separate relatively nonaggressive appearing cases of leiomyosarcoma in the wrist and the thigh, encasing a superficial wrist vein and the greater saphenous vein respectively. The leiomyosarcoma of the right wrist was found in a 65-year-old male who presented with a non-painful ulnar sided nodule progressing in size for one year. Similarly, the leiomyosarcoma of the left thigh was discovered in a 52-year-old man who presented with a non-painful "knot" he had noticed enlarging over the course of just a few months. Review of the literature suggests less than 50 patients have been reported to have leiomyosarcoma of the great saphenous vein from 1868 to 2020 (Tresgallo-Parés et al., 2021). The number of vascular leiomyosarcomas arising in the superficial veins of the wrist are even lower with a 2006 case report from the Annals of Vascular Surgery suggesting only one previous case has arisen from the superficial vein over the dorsal wrist (Fu, T. Y et.al., 2007). The purpose of this report is to draw attention to a rare yet grave diagnosis to ensure that leiomyosarcoma is at least included in the differential diagnosis of rapidly enlarging nontender soft tissue masses of the extremities that encase veins.Item Tracheobronchopathia Osteochondroplastica Presenting as Acute Shortness of Breath(2024-03-21) Qadri, Syed; Pratka, Holden; Schultz, SteveAn outpatient case of tracheobronchopathia osteochondroplastica is reported in a 58-year-old male presenting from the Dallas-Fort Worth area. Tracheobronchopathia osteochondroplastica (TO) is an exceedingly rare, non-neoplastic tracheobronchial condition characterized by multitudinous sessile, cartilaginous nodules, most prominent along the anterolateral walls and projecting into the lumen of the trachea and bronchi (Silveira et al 2017). Here we highlight the case of a middle-aged male presenting to the outpatient clinic with acute shortness of breath and cough. Chest CT without contrast was promptly ordered, displaying anterior and lateral endotracheal submucosal nodularity. Subsequent bronchoscopy confirmed the diagnosis of TO. Diagnosis and management of this condition is limited by clinicians' lack of familiarity with this pathology. Unfortunately, because of its rarity and potentially broad array of presenting symptoms, diagnosis may often be delayed resulting in increased stress for the expectant patient. The time between first symptoms and ultimate diagnosis is about 4 years in most cases; however, can be greater than 25 years according to some reports (Jabbardarjani et al 2008). Radiographically, tracheobronchopathia osteochondroplastica can look similar to other conditions in the trachea such as relapsing polychondritis, granulomatous processes such as granulomatosis with polyangiitis, and sarcoidosis. Amyloidosis, inflammatory bowel disease, and certain infectious processes should be considered as well. As such, the purpose of this case report is to increase clinical awareness of this rare condition to potentially expedite its management and diagnosis.