Browsing by Author "Tenente, Joana"
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- An atypical presentation of pediatric malignant spinal cord compressionGaia, Maria João; Lopes, Vilma; Tenente, Joana; Coelho, Janine; Real, Marta Vila; Santos, FátimaBackground: Malignant spinal cord compression (MSCC) is a rare but serious complication of pediatric malignancies that can result in permanent neurologic deficits. The prognosis depends on neurological symptoms at diagnosis. Case report: A nine-year-old girl was evaluated for worsening pain in the left anterior iliac spine with one month of evolution. Over the next two days, she showed progressive gait instability and low back pain. During hospitalization, she developed decreased strength and sensitivity in the lower limbs, hyperreflexia with clonus, Babinski sign, and inability to walk. Magnetic resonance imaging showed a compressive intracanalicular lesion at D8-12, later identified as Ewing sarcoma. The patient was treated and had no sequelae. Conclusion: Clinicians should be aware that MSCC may have an atypical presentation, such as pain in an unusual location, and early recognition is essential to improve prognosis.
- Dermatology clinical casePublication . Leitão, Cátia; Pereira, Isabel; Tenente, Joana; Vila-Real, Marta; Oliveira, Ana; Leite, Ana LuísaIncontinentia pigmenti is an X-linked neuroectodermal dysplasia. It is a rare genetic disease with multiorgan involvement, and hence a multidisciplinary approach is of paramount importance. Although diagnosis is based on clinical findings, genetic molecular testing can be performed to confirm diagnosis and allow future genetic counselling. The authors describe the case of a 4-month-old girl accidentally diagnosed with incontinentia pigmenti following routine physical examination in the Emergency Department. Timely diagnosis enabled appropriate multidisciplinary approach and follow-up.
- Neonatal cranial bone depressionPublication . Tenente, Joana; Cardoso, Ivana; Vinhas da Silva, António; Torres, JacintoA female preterm was admitted to the Neonatal Intensive Care Unit for late prematurity and very low weight. The physical examination was normal. On the third day of life, a hard left, non-painful parietal depression was noted, with no evidence of neurological impairment. Head computed tomography (CT) showed focal sinking of the left parietal bone posteriorly to the coronal suture. A watchful attitude was adopted and the patient was discharged on day 28. The diagnosis was a “ping-pong fracture”, which can occur iatrogenically or spontaneously in uterus. This diagnosis can be confirmed by x-ray or CT scan and the prognosis is usually good, with complete deformity regression. At two months, the parietal fracture was barely perceptible, and neurological examination was normal.