Desmoid tumor of rectus abdominis presenting with Grey-Turner's and Cullen's Sign: A report of a rare case

Abstract

Desmoid tumor of rectus abdominis presenting with Grey-Turner's and Cullen's sign is rare. Herein, we report desmoid tumor of rectus abdominis in a 64-year-old multiparous female who presented with ecchymosis involving left flank and around the umbilicus. Histopathological examination of biopsy from the tumor confirmed the diagnosis of the desmoid tumor. She was referred to a surgeon for radical resection.

Malignant Syphilis as an Initial Presentation of HIV Infection: A Case Report

“…This disease is characterized by marked prodromal constitutional symptom, such as fever, malaise, myalgia, headache, and weight changes over the span of 4 weeks before the appearance of skin lesions. 1 Characteristic morphology of lesions, positive serological tests for syphilis, characteristic histopathology, and resolution of lesions following administration of penicillin therapy confirmed the clinical diagnosis of MS. 1 Fisher et al 2 defined the classical diagnostic criteria for MS as: compatible macroscopic and microscopic skin lesions, high serology titer, Jarisch-Herxheimer reaction (JHR) upon starting antibiotic treatment, and rapid clinical resolution with treatment. Here we report a case of MS and this was the initial presentation of HIV infection.…”

“…Malignant syphilis (MS) is a rare form of secondary syphilis which is frequently associated with human immunodeficiency virus (HIV) infection. 1 Since the beginning of the HIV epidemic, the incidence of MS has been steadily rising, making it a disease of vital recognition for any patient with suspicious cutaneous lesions. MS, also referred in the literature as syphilis maligna praecox, lues maligna, or rupioid syphilis, is defined as the presence of pleomorphic multiple round to oval papules, papulopustules, or nodules with ulceration, without central clearing, and occasionally exhibit a lamellate brown to black rupioid crust.…”

“…Malignant syphilis (MS) is a rare form of secondary syphilis which is frequently associated with human immunodeficiency virus (HIV) infection 1 . Since the beginning of the HIV epidemic, the incidence of MS has been steadily rising, making it a disease of vital recognition for any patient with suspicious cutaneous lesions.…”

“…MS, also referred in the literature as syphilis maligna praecox, lues maligna, or rupioid syphilis, is defined as the presence of pleomorphic multiple round to oval papules, papulopustules, or nodules with ulceration, without central clearing, and occasionally exhibit a lamellate brown to black rupioid crust. This disease is characterized by marked prodromal constitutional symptom, such as fever, malaise, myalgia, headache, and weight changes over the span of 4 weeks before the appearance of skin lesions 1 …”

Abdominal Physical Signs of Inspection and Medical Eponyms

“…59 Grey Turner sign is found in a number of conditions associated with retroperitoneal or intra-abdominal bleeding such as a leaky abdominal aortic aneurysm, retroperitoneal bleeding caused by trauma, spontaneous hemorrhage of the abdominal wall after coughing, desmoid tumor of the rectus abdominis muscle, adrenal cyst, and intra-aortic balloon pump insertion. [60][61][62][63] It can take 2-3 days for the appearance of Cullen and Grey Turner signs to appear, depending on the stage of red blood cell breakdown; the skin turns from green/ yellow to a purplish color. 10 In a randomized, double blinded trial assessing the course of aprothinin and glucagon on acute pancreatitis in 257 patients, Grey Turner sign was observed in only two patients (0.78%).…”