Tehran University of Medical Sciences Case Reports in Clinical Practice 2538-2683 6 S1 2022 07 06 265 268 Hajrah Ahmed General Surgery Surgical Unit II, Abbasi Shaheed Hospital, Karachi, Pakistan. Ayesha Siddiqui House Officer, Surgical Unit II, Abbasi Shaheed Hospital, Karachi, Pakistan. Kanwal Irshad General Surgery Surgical Unit II, Abbasi Shaheed Hospital, Karachi, Pakistan. Muhammad Jamaluddin Karachi Medical & Dental, Karachi, Pakistan. 2020 12 07 2021 12 01 Squamous Cell Carcinoma (SCC) of the scrotum has a considerably low incidence and is directly linked to exposure to occupational carcinogens. We present a case of an 80-year- old male patient with a long history of multiple painless swellings in the scrotum. The investigations showed the lesions confined to the skin with the involvement of some draining lymph nodes, and the histopathology came to be Scrotal Squamous Cell Carcinoma. Due to lymph node involvement, the lesions were of TNM (Tumor size, Nodal involvement, Distant Metastasis) staging 4 and Lowe’s stage B. Wide surgical excision combined with radiotherapy was done. There is a lack of research about the disease worldwide and in Pakistan, which warrants further interest in optimizing diagnostics and therapeutics modalities and assessing geographical variation. https://crcp.tums.ac.ir/index.php/crcp/article/view/429

Tehran University of Medical Sciences Case Reports in Clinical Practice 2538-2683 6 S1 2022 07 06 269 270 Mohsen Esfandbod Department of Hematology and Oncology, Imam Khomeini Hospital Complex, Tehran University Medical Science, Tehran, Iran. Bahareh Shateri Amiri Department of Internal Medicine, Imam Khomeini Hospital Complex, Tehran University Medical Science, Tehran, Iran. 2020 12 25 2021 01 18 35-year-old woman presented to the dermatology clinic complaining of lax skin and atrophic and pendulous plaques in axillary, inguinal folds, and deltoid region. Initially, lesions were indurated plaques, which slowly became wrinkled.Histopathologic evaluation showed Pandermal and subcutaneous infiltrate of atypical lymphocytes admixed with evenly distributed epithelioid and multinucleated giant cells, many of which contain numerous nuclei. Histopathology and clinical findings were consistent with the diagnosis of Granulomatous slack skin. https://crcp.tums.ac.ir/index.php/crcp/article/view/444

Tehran University of Medical Sciences Case Reports in Clinical Practice 2538-2683 6 S1 2022 07 06 271 273 Mohammad Reza Sasani Department of Radiology, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran. Mansoureh Chegeni Department of Radiology, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran. 2021 01 15 2021 04 12 Ectopic pregnancy (EP) is a life-threatening condition in pregnancy. EP after partial or total salpingectomy on the same side is rare; the mechanism of this condition is not clear. However, three hypotheses have been reported. We present a case of interstitial EP in a woman who underwent ipsilateral total salpingo-oophorectomy for endometriosis 3 years ago. The current issue highlights that total salpingectomy does not exclude ipsilateral interstitial EP. Therefore, clinicians should be aware of this diagnosis to prevent catastrophic consequences. https://crcp.tums.ac.ir/index.php/crcp/article/view/458

Tehran University of Medical Sciences Case Reports in Clinical Practice 2538-2683 6 S1 2022 07 06 274 278 Marziyeh Ghalamkari Department of Hematology and Medical Oncology, Iran University of Medical Science, Tehran, Iran. farhad shahi Department of Hematology and Medical Oncology, Breast Disease Research Center, Tehran University of Medical Science, Tehran, Iran. Samaneh Salarvand Department of Hematology and Medical Oncology, Breast Disease Research Center, Tehran University of Medical Science, Tehran, Iran. Aahmad khajeh-mehrizi Department of Hematology and Medical Oncology, Imam Khomeini Hospital Complex, Tehran University of Medial Science, Tehran, Iran. 2021 01 21 2021 02 01 Multiple myeloma (MM) has been suggested to associate with other solid tumors. Myeloma or its chemotherapy regimens may be a risk factor for developing primary and secondary malignancies. But the coexistence with other tumors is rare. We report an old patient simultaneously suffering from MM and gastric adenocarcinoma. https://crcp.tums.ac.ir/index.php/crcp/article/view/463

Tehran University of Medical Sciences Case Reports in Clinical Practice 2538-2683 6 S1 2022 07 06 279 283 Yazdan Ghandi Department of Pediatric Cardiologist, Amir-Kabir Hospital, Arak University of Medical Sciences, Arak, Iran. Nooshin Sadjadei Department of Pediatric Gastroenterology, Amir-Kabir Hospital, Arak University of Medical Sciences, Arak, Iran. Mahya Mobinkhaledi Department of Pediatrics, Faculty of Medicine, Arak University of Medical Sciences, Arak, Iran. 2021 01 25 2021 04 12 Kawasaki disease (KD) is a systemic vasculitis of small and medium-sized vessels that mainly influences children under five. In the classic diagnostic criteria of KD, there is no Gastrointestinal involvement. Myocarditis is one of the unusual cardiovascular complications of KD, and there is only a very minority of patients have symptoms suggestive of clinical myocarditis. Case Presentation: We reported a 7-year-old boy admitted with a high fever and bloody diarrhea. The stool exam revealed many white blood cells (WBCs) and red blood cells (RBCs). On the 5th day of admission, we found bilateral cervical lymphadenopathy, bilateral nonexudative conjunctivitis, cracked lips, and maculopapular rashes over the extremities. Echocardiography revealed severe mitral regurgitation (MR) with reduced ejection fraction (EF). We treated the patients with oral high-dose aspirin (100 mg/kg/d) plus intravenous immunoglobulin (IVIG 2 gr/kg). Cardiovascular complications such as acute clinical myocarditis should be highly suspected in any patient KD with persistent bloody diarrhea. https://crcp.tums.ac.ir/index.php/crcp/article/view/464

Tehran University of Medical Sciences Case Reports in Clinical Practice 2538-2683 6 S1 2022 07 06 284 287 Abdolreza Ghoreishi Department of Neurology, Vali-e Asr Hospital, School of Medicine, Zanjan University of Medical Science, Zanjan, Iran. Ghazal Malekmahmoudi Department of Neurology, Vali-e Asr Hospital, School of Medicine, Zanjan University of Medical Science, Zanjan, Iran. Mohammad Hadi Molseghi Department of General Surgery, School of Medicine, Zanjan University of Medical Sciences, Zanjan, Iran. Mehrdad Gholizadeh Department of Neurology, Vali-e Asr Hospital, School of Medicine, Zanjan University of Medical Science, Zanjan, Iran. Mansoureh Sabzehparvar Department of Neurology, Vali-e Asr Hospital, School of Medicine, Zanjan University of Medical Science, Zanjan, Iran. 2021 02 08 2021 04 12 Intracerebral hemorrhage is a dangerous occurrence in patients. This may occur due to hypertension, cerebral amyloid angiopathy, Drug usage, anticoagulants, antithrombotic, coagulopathies, tumors, arteriovenous malformation (AVM), and aneurysmal rupture. Bilateral thalamic hemorrhages are rare. This article presents a rare case of Simultaneous recurrent bilateral hypertensive thalamic hemorrhage in a 57-year-old woman with right hemiparesis. https://crcp.tums.ac.ir/index.php/crcp/article/view/471

Tehran University of Medical Sciences Case Reports in Clinical Practice 2538-2683 6 S1 2022 07 06 288 291 Vajihe Marsusi Department of Obstetrics and Gynecology, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran. Ashraf Sadat Jamal Department of Obstetrics and Gynecology, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran. Laleh Eslamian Department of Obstetrics and Gynecology, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran. Maasoumeh Saleh Department of Obstetrics and Gynecology, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran. Behnaz Nouri Department of Obstetrics and Gynecology, Faculty of Medicine, Alborz University of Medical Sciences, Karaj, Iran. Danial Dehghan Department of Obstetrics and Gynecology, Faculty of Medicine, Alborz University of Medical Sciences, Karaj, Iran. 2021 02 13 2021 04 14 Autoimmune hemolytic anemia (AIHA) may be the first manifestation of systematic lupus erythematosus (SLE). Antierythrocyte antibodies in SLE are mainly warm-type Immunoglobulin G (IgG), but mixed-type AIHA is also reported. Cold antibody-mediated hemolytic anemia is extremely rare in SLE. Only a few cases have been reported in the literature. A 37-year-old pregnant woman presented with features of hemolytic anemia and was later diagnosed as an SLE case. Although rare, a new case report highlights that cold-type autoimmune hemolytic anemia may be an early manifestation of SLE. https://crcp.tums.ac.ir/index.php/crcp/article/view/482

Tehran University of Medical Sciences Case Reports in Clinical Practice 2538-2683 6 S1 2022 07 06 292 297 Vajihe Marsusi Department of Obstetrics and Gynecology, Faculty of Medicine, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran. Ashraf Sadat Jamal Department of Obstetrics and Gynecology, Faculty of Medicine, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran. Maasoumeh Saleh Department of Obstetrics and Gynecology, Faculty of Medicine, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran. Behnaz Nouri Department of Obstetrics and Gynecology, Faculty of Medicine, Alborz University of Medical Sciences, Karaj, Iran. 2021 02 13 2021 04 14 Thrombotic Thrombocytopenic Purpura (TTP) is an acute, rare, potentially life-threatening disorder presenting with thrombocytopenia, hemolytic anemia, and clinical consequences of microvascular thrombosis caused by a deficiency of ADAMS13 [1, 2]. The incidence of acquired TTP is approximately three cases per one million adults per year, based on the Oklahoma TTP-Hemolytic uremic syndrome (HUS) Registry [3]. Here, we present a case of TTP with persistent severely deficient ADAMS13 activity and recurrent relapses. She had a refractory relapse in the third trimester of pregnancy, complicated with superimposed severe preeclampsia and sepsis, and finally expired due to intracranial hemorrhage (ICH). https://crcp.tums.ac.ir/index.php/crcp/article/view/483

Tehran University of Medical Sciences Case Reports in Clinical Practice 2538-2683 6 S1 2022 07 06 298 302 Ruohollah Seddigh Research center of addiction and risky behavior, Department of psychiatry, school of medicine, Iran University of Medical Sciences, Tehran, Iran. Amir-Abbas Keshavarz-Akhlaghi Research center of addiction and risky behavior, Department of psychiatry, school of medicine, Iran University of Medical Sciences, Tehran, Iran. Mahdieh Saeidi Department of Psychiatry, School of Medicine, Iran University of Medical Sciences, Tehran, Iran. 2021 02 26 2021 05 10 Stress has a significant role in developing Acute and Transient Psychotic Disorder (ATPD). The condition resolves after stress termination without relapse for long years in many cases. So this kind of psychosis can be different from other psychosis in terms of etiology and prognosis. We report an 18-year-old male patient with an acute and transient psychotic disorder who experienced a psychotic episode after a rape. His psychosis was remitted without any antipsychotic medications. This case raises an important question: Why should this kind of psychosis be classified under a psychotic branch of psychiatric disorders classification and not under more benign disorders such as adjustment disorder. https://crcp.tums.ac.ir/index.php/crcp/article/view/485