Medicine and Health Sciences Commons^™

Beyond The Skin: A Case Report Of Vaginal Melanoma, Brittany Gilbert, Wm Tanner Gilbert, Ardeshir Hakam, Lynne J. Goebel

Marshall Journal of Medicine

Mucosal melanomas are rare, accounting for only 1.4% of all melanomas. Only 18% of mucosal melanomas are vulvovaginal in origin, making it exceedingly rare. Mucosal melanomas typically carry a worse prognosis than those arising from cutaneous sites with a higher risk of recurrence and disseminated disease. We report a rare case of vaginal melanoma presenting as postmenopausal bleeding and discuss management of this disease.

Acute Marjolin Ulcer From A Dog Bite, Brandon S. Henderson, Katalin Z. Kovacs, Lynne J. Goebel

Marshall Journal of Medicine

Marjolin ulcers are cancers, usually of squamous cell carcinoma pathology, that occur in scars or wounds. They are classically described in burn victims but can occur with other types of trauma and are rarely seen in association with bite wounds. Marjolin ulcers typically have a latent period of many years post-injury until the development of malignancy, but there are a few case reports of an exceedingly rare acute form. We present a case of a 78-year-old female who developed a Marjolin ulcer one month after sustaining a dog bite to the left index finger.

Chronic Inflammatory Demyelinating Polyneuropathy (Cidp) In A Patient With Diabetes: A Primary Care Perspective, Jordan Dever, Adam M. Franks, Laura M. Given, William Rollyson, Adrienne Mays-Kingston

Marshall Journal of Medicine

Chronic inflammatory demyelinating polyneuropathy (CIDP) is a recurrent and progressive disease that causes proximal, symmetrical extremity weakness. The disease is diagnosed using clinical features, electrophysiologic testing, albumino-cytological disassociation in the cerebrospinal fluid, and sural nerve plexus biopsy. However, because of the low sensitivity of diagnostic criteria and other similar neuropathies, including diabetic polyneuropathy (DPN), accurate diagnosis is difficult. Differentiating between these diseases is especially important as CIDP’s changes are reversible and DPN’s are not. Making this differentiation allows for symptomatic improvement in a patient’s quality of life that would not be achieved otherwise. Early recognition and treatment, with modalities including …

Reducing Overtreatment Of Urinalysis In Obstetric Triage Patients, Emelia Winston, Rachel Marteney, Erin Casey, Kevin Conway

Marshall Journal of Medicine

Introduction

Overtreatment of asymptomatic bacteriuria (ASB) is a major issue that has been coming to the forefront in recent decades. Studies have shown that it can lead to adverse side effects, extra costs, and antimicrobial resistance. The purpose of this study was to determine the number of patients presenting to obstetric triage who were overtreated for a urinalysis (UA) and to see if an educational intervention could reduce the incidence of overtreatment for suspected ASB.

Methods

This was a retrospective chart review analyzing UA results and outcomes of OB triage patients that came through labor and delivery before and after …

Chronic Abdominal Pain In A Geriatric Patient: A Rare Case Of A Spigelian Hernia, Thomas D. Wright, Olumayowa Dayo, Lynne J. Goebel

Marshall Journal of Medicine

We present a case of Spigelian hernia in a 77-year-old patient to highlight the difficulty in making this diagnosis and to raise awareness of this rare condition among physicians who care for geriatric patients with chronic bouts of abdominal pain. The patient presented to the emergency department with a two-day complaint of abdominal pain after three years of similar recurrent attacks. Results of the physical examination and computed tomography (CT) of the abdomen were consistent with a left-sided Spigelian hernia. Operative repair was performed using robotic-assisted reduction and the patient recovered without any complications.

Reflections On West Virginia's Early Covid-19 Experience, Stephen M. Petrany, Deb Koester, Robert Walker

Marshall Journal of Medicine

No abstract provided.

Rectal Neuroendocrine Tumor In A Patient With Chek2 Mutation, Shefali Khanna, Deena Dahshan, Erin Fankhanel, Doreen Griswold, Lynne J. Goebel

Marshall Journal of Medicine

We provide new information about CHEK2 mutation in association with a rectal neuroendocrine tumor (NET). A 67-year-old Caucasian woman diagnosed with estrogen receptor positive ductal carcinoma in situ breast cancer underwent genetic testing, revealing a CHEK2 mutation that prompted her to have a colonoscopy. This revealed a polyp with immunohistochemical staining positive for markers classically associated with NETs. Six-month follow up surveillance colonoscopy after initial polyp removal found no evidence of recurrence. While the CHEK2 mutation is known to be associated with adenocarcinomas, there is only one other reported case of its association with NETs.