Mahsa Karbasi

and 5 more

IntroductionOsteoid osteoma (OO) is a benign osteoblastic lesion that occurs primarily in young men and accounts for approximately 11% of all benign bone tumors (1). Almost 80% of all “OO” are detected in patients younger than 30 years old. These lesions are generally seen in the shaft of the long bones, especially the femur or tibia, in the lower limb. They are only rarely detected in the flat bones (2-5). “OO” includes a well-defined osteoblastic mass, known as a nidus, which is surrounded by the reactive bone sclerosis zone. Following nidus excision, the sclerosis zone gradually disappears, indicating a secondary, reversible alteration (6). Patients with OOs typically report generalized pain at the site of their benign tumors, and their pain can be more severe and frequent at night. Non-steroidal anti-inflammatory drugs (NSAID) and salicylates are commonly used to manage the pain (7).It is extremely rare for OO to occur in the scapula, especially the coracoid process (CP), therefore it is not commonly recognized as a differential diagnosis in young people with shoulder pain (8). Various therapeutic approaches have been proposed for treating these lesions, including complete surgical excision and percutaneous radiofrequency ablation (RFA) (9). Nevertheless, it is critical to note that the use of any of these treatment strategies may lead to permanent impairment of the articular cartilage or physics in younger patients (10). Herein, we present the first case of OO of the base of CP, treated successfully with RFA in the literature.

Mahsa Karbasi

and 5 more

IntroductionHeterotopic pregnancy (HP) is characterized by the existence of intrauterine and ectopic pregnancies occurring simultaneously(1). This is a rare yet serious condition that can be spontaneous or resultant from assisted reproductive technology (ART)(2). While spontaneous HP has a reported frequency of 1 in 50,000 to 1 in 10,000(3, 4), ART-related cases of HP have been estimated to occur in 0.2%-1% of patients(5). Heterotopic Cesarean scar pregnancy (HCSP) involves the occurrence of a Cesarean scar pregnancy (CSP) accompanied by intrauterine pregnancy (IUP), which poses a high risk of catastrophic complications such as uterine rupture and massive hemorrhage(6, 7, 8). An extremely low incidence of HCSP has been reported during spontaneous cycles. Nevertheless, due to the rising occurrence of Cesarean section delivery and the expanding recourse to ARTs, the prevalence of HCSP is anticipated to increase(9, 10, 11). Due to the considerable risk for fetal and maternal morbidity and mortality, timely and precise diagnosis of HCSP is vital(12). The principal investigative approach that holds the greatest significance involves sonographic and Doppler flow-based evaluations(13). In the management of HCSP, preserving the coexistent presents a significant challenge. Guidelines for managing HCSP while preserving the IUP are not universally standardized due to the rarity of this condition(14). The typical method is to terminate the implantation located within the scarred area, if deemed necessary, at the potential expense of terminating the IUP(7). The available literature reveals a range of techniques for managing this condition, with medical and surgical approaches being two distinct options. The surgical interventions, which may involve laparoscopic or hysteroscopic excision of the masses, have been linked with potential complications like the loss of pregnancy and preterm delivery. In our research, we detail a case of HCSP, which was addressed through a combination of exploratory laparotomy and dilation and curettage (D&C) procedures.