A final Computer-assisted planning with 3D printing jaw reconstruction after two previous unsuccessful surgical reconstructions which leaded to pain, osteomyelitis and severe mandibular bone loss. The conjunction of actions used in this case allowed a successful and predictable outcome.

Achilles tendon rupture is a well-documented adverse effect of Fluoroquinolones; however, herein we present a case of complete iliopsoas and Achilles, and partial semimembranosus tendon rupture secondary to Levofloxacin.

The present case report illustrates the rehabilitation of a 12-day old neonate with cleft palate. Since the palatal arch of the neonate was very small, a feeding spoon was innovatively modified to obtain the impression. The obturator was fabricated on the same day and delivered in one appointment.

We herein report an exceedingly rare case of Evans syndrome with associated tubercular pleural effusion. The patient was initially treated as autoimmune hemolytic anemia. However, the development of thrombocytopenia led to the subsequent diagnosis of Evans syndrome. The co-existence of tuberculosis resulted in additional difficulty during treatment with immunosuppressive medications.

One of the most recently identified types is Leukocyte chemotactic factor 2 amyloidosis (LECT 2) which was found to be common in certain ethnic backgrounds. It is suggested that the diagnosis of this type is vital to prevent any therapy-related complications when it is erroneously diagnosed as AL amyloidosis.

As far as we know, this is the 51st case of Hennekam Syndrome (HS) worldwide and the first one in an African American.1 Our patient met all diagnostic criteria for HS, type 2 (FAT4 mutation), as the disease onset was in adolescence.2,3

Simultaneous Echinococcal Superinfection in a Patient with Polycystic Liver Disease.Cicerone O.*, Lissandrin R.^, Brunetti E.^, Maestri M.**: Fondazione IRCCS Policlinico San Matteo, Chirurgia Generale I, PaviaTropicali, Pavia

Systemic lupus erythematosus (SLE; lupus) is an autoimmune disease. The common neurological manifestations are psychosis, cognitive dysfunction, and headache. Transverse myelitis (TM) may be the first manifestation of lupus. We describe one such case in which TM was the only presentation of SLE.

Traditional palatal and vestibular surgical approaches for removing deeply impacted mesiodens with a crown facing the nasal floor are accompanied by significant complications. Herein, we describe a novel modified intranasal approach to minimize the complications. Also, it can be performed under local anesthesia with proper preoperative workup.

Toxic epidermal necrolysis (TEN) is a serious drug reaction. Its proper cure would be challenging during COVID-19 outbreak because of a dilemma regarding selecting the immunosuppressive drug. In this case presentation, we report a case of TEN who treat successfully with cyclosporine during COVID-19 outbreak in a referral COVID-19 hospital.

Parenchymal sparing surgical (PSS) strategy allowed to plan a one-stage systemic extended posterior right sectionectomy with resection of the dorsal subsegment S1 in patient with 11 bilobar CRC metastases. PSS liver surgery has the greatest potential for implementation in modern medicine conditions.

We report the successful surgical closure of right pulmonary artery to left atrium fistula (RPALAF) with secondary atrial septal defect (ASD) in 3.5 years old girl, who had suffered with central cyanosis and exertional dyspnea.

Indwelling arterial catheters are used routinely for continuous haemodynamic monitoring during major surgery and in critically ill patients. Major complications are rare. We describe two cases of patients in which arterial catheterisation was associated with acute radial arterial thrombosis and radial ischaemic neuropathy. Timely recognition was paramount to successful management.

In this clinical image, we presented a rare case of shortness of breath as a symtom of McKittrick-Wheelock syndrome(MWS). The patient’s symptom and electrolyte disorders improved with the resection of the rectal villous tumor. We should aware of this rare symtom in case of the diagnosis of MWS.

Key Clinical Message: In patients presenting with hyperinsulinaemic hypoglycaemia with a non-pancreatic neuroendocrine tumour, the diagnosis of an ectopic insulin-secreting tumour should be considered, and investigated further with confirmatory insulin staining.

Friedreich ataxia is the most common inherited ataxia in the world, but yet to be reported in black African. We report the first genetically confirmed case in a West African family. Studying genetic diseases in populations with diverse backgrounds may give new insights into their pathophysiology for future therapeutic targets.

Primary renal osteosarcoma is exceedingly rare tumor with poor prognosis. It has tendency to spread to distant sites . we report the case of a 43-year-old female who presented with flank pain, gross hematuria, weakness and weight loss and was treated with diagnosis of primary renal osteogenic sarcoma

An 88-year-old man ingested coins accidentally and developed mediastinitis and septic shock. Esophageal injuries by sharped-shape foreign bodies are often reported, but esophageal perforation by round coins is rare. Even rounded-shape foreign bodies that are unlikely to injure esophagus may lead to severe outcomes.