Among the occult spinal dysraphisms, neurenteric cysts (NECs) are rare and are thought to arise due to a failure of the separation of the primitive endoderm and ectoderm. Patients experience various neurological symptoms depending on the location of the lesion. As the epithelial morphology of NECs share similarities with other intracranial and intraspinal cystic growths, the definitive diagnosis of NEC can be made after a histochemical analysis with endodermal markers. Complete resection is associated with the lowest disease recurrence rate.
Severe acute respiratory syndrome-coronavirus 2 (SARS-CoV-2), the virus strain that causes coronavirus disease 2019 (COVID-19), was first identified in Wuhan, China in December 2019. It spread to several countries across continents and infected more than one million people within three months. While there is no consensus on the treatment of the disease yet, understanding the virus and its transmission is a cardinal priority. SARS-CoV-2 can be transmitted through bodily fluid. Upon inoculation, the surface enzyme angiotensin-converting enzyme 2 (ACE2) acts as a receptor protein for viral entry. The mean incubation period is 5.1 days, and infected individuals can exhibit a variety of symptoms from fever, cough, dyspnea, and respiratory failure to even multiorgan failure. Given the current situation, it is of paramount importance to understand the virus as thoroughly as possible. In this review, we discuss the background, epidemiology, possible pathophysiology, clinical presentation, and diagnostic studies related to SARS-CoV-2 infection. We also elaborate on the current research and evidence on treatment options and vaccine development based on the literature.
Gastrointestinal stromal tumor (GIST) is one of the most common spindle cell neoplasms of the alimentary system, and can arise anywhere along the gastrointestinal tract (GI). Its incidence rate is up to 22 cases per million, with a minor geographic variation. GIST is thought to originate from interstitial cell of Cajal, and its pathogenesis is related to molecular defects, such as KIT receptor tyrosine kinase or platelet-derived growth receptor alpha gene activation. While the majority of GISTs are known to show a benign disease course, metastases of high-grade forms to different organ systems have been seldom reported. We present a case with an unprecedented metastasis of GIST to the breast. The patient is a 62-year-old female with a history of the primary resection of GIST from the small intestine. Her disease course was initially complicated by multiple metastases, solely localized to the liver for which she had a living-donor liver transplant. The tumor harbored both KIT exon 11 and exon 17 mutation. Fourteen months post-transplant, the patient was found to have metastatic GIST on her breast biopsy. GIST metastasis to the breast is extremely rare. A consideration of this spindle cell neoplasm as a differential is recommended when clinical suspicion arises. The pathophysiology, current diagnostic tool, grading system, and treatment of this tumor are discussed.
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