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This article reports a case of toxic epidermal necrolysis (TEN) associated with the use of levetiracetam, an anticonvulsant medication. The patient, a 47-year-old woman with epilepsy, developed severe skin and mucosal lesions after taking levetiracetam for four weeks. The severity of the condition was assessed using the SCORTEN score, which predicted a 35% mortality rate. Levetiracetam was discontinued, and the patient was treated with systemic corticosteroids and intravenous immunoglobulin, resulting in progressive improvement. Although levetiracetam-induced TEN is extremely rare, healthcare providers should be aware of the potential risks. [Extracted from the article]

Background: Neuroendocrine neoplasms (NENs) can arise in most of the epithelial organs of the body and are not a rare condition in the gastrointestinal tract (GIT). The presence of NENs in GIT associated with other secondary primary malignancies (SPM) has been considered an exotic event. This study aims to describe the case reports of NENs accompanied by synchronous primary tumors. Methods and findings: We performed a systematic literature search of the databases Scopus, PubMed, Scielo and LILACS to identify case reports that described the presence of NENs in GIT with SPM. 78 case reports were included. The mean of age of the cases was 60.2 years. 60% were male. 95.4% were NENs G1. 17 cases of NENs had metastasis. 80% of SPM were recognized in the GIT (36% in stomach, 27% in large intestine, 11.2% in small intestine, and 5.6% in esophagus). The most common type of SPM was adenocarcinoma (49.4%), followed by GIST (13.5%), other NENs in different GIT segment (7.9%), lymphoma (6.8%), and squamous cell carcinoma (4.5%). The most common tumor in GIT was adenocarcinoma (97.6%) and the presence of adenocarcinoma in the same segment of GIT was found in 68.4% of the cases. Association between adenocarcinomas and NENs in GIT (p:<0.0001) and adenocarcinoma and tumor in the same segment of GIT location were observed (p<0.001). Conclusion: These results demonstrate that NENs with SPM are not a rare condition. Several theories have been proposed to explain this association; one of these is the ability of NENs to generate synchronous tumors by autocrine and paracrine effect. We observed an association between adenocarcinomas and NENs in the same segment of GIT. [ABSTRACT FROM AUTHOR]

Juvenile polyposis syndrome (JPS) is an infrequent autosomal dominant hereditary predisposition to the occurrence of hamar-tomatous polyps in the colon and rectum. We describe the case of a 12-year-old boy with JPS associated with an abdominal tumor. Histological sections of the abdominal tumor showed components of adenocarcinoma, osteosarcoma, and choriocarcinoma. Immunohistochemistry was AE1/AE3, CK7, HCG and SALL4 positive. Juvenile polyposis syndrome patients are at increased risk of colorectal adenocarcinoma. However, we present a case of an adenocarcinoma associated with other unusual components. This association has not been reported before. [ABSTRACT FROM AUTHOR]