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Dario Amore, Roberto Scaramuzzi, Davide Di Natale, Carlo Curcio
The advantages of thymectomy as part of the treatment of myasthenia gravis has been demonstrated repeatedly in the literature. Both single-institution and multi-institution trials have shown robotic thymectomy to be safe, feasible and associated with better early clinical outcomes than the trans-sternal approach. Most reports have also documented the superiority of robotic technology in the dissection of the superior mediastinum over conventional thoracoscopy, thanks to instruments with more degrees of movement and freedom...
2018: Journal of Visualized Surgery
Vera Spatenkova, Pavlina Krejzarova, Jaroslav Jedlicka
Introduction: Dysphagia is a risk factor for aspiration pneumonia and acute respiratory failure in acute stroke patients. Dysphagia lusoria is caused by compression on the esophagus from artery lusoria, when the aberrant right subclavian artery arises from the descending aortic arch. We present a rare case report of pre-stroke undiagnosed dysphagia lusoria as a cause of aspiration pneumonia with acute respiratory failure in a 67-year-old female patient admitted with a minor left intracerebral hemorrhage in the left basal ganglia...
2018: SAGE Open Medical Case Reports
Dongliang Bian, Feng Zhou, Weiguang Yang, Kaixuan Zhang, Linsong Chen, Gening Jiang, Peng Zhang, Chunyan Wu, Ke Fei, Lei Zhang
Background: Thymoma, though a rare tumor disease, is the most common tumor of the anterior mediastinum. However, tumor size, as a critical factor, has been underestimated. Results: Age, advanced tumor stage, and preoperative radiotherapy were poor prognostic factors of overall survival (OS) and disease specific survival (DSS) ( P < 0.05 for all). Besides, tumor size was significantly related to survival. The larger tumor size indicated the less OS and DSS ( P < 0...
February 23, 2018: Oncotarget
Kyung Won Doo, Bomi Kim
Castleman's disease (CD) is an uncommon benign lymphoproliferative disorder which most commonly involves the mediastinum but rarely affects the pleura. We report a case of unicentric CD that presents as a pleural mass in a 45-year-old man, which was subsequently resected followed by an unexpected diagnosis on histologic examination. Although rare, CD should be included in the differential diagnosis of well-enhancing pleural mass.
February 2018: Radiology case reports
Jun Wang, Ning Wei, Yimin Lu, Xiaoying Zhang, Nanqing Jiang
BACKGROUND: We aimed to compare mediastinoscopy-assisted esophagectomy (MAE) with the Ivor Lewis procedure in T2 middle and lower thoracic esophageal carcinoma patients in fields of perioperative complications and overall survival (OS). METHODS: The clinical data of 112 T2 esophageal cancer patients who received MAE (n = 31) or Ivor Lewis procedure (n = 81) from January 2010 to December 2015 were retrospectively analyzed in propensity score analysis. Thirty-eight T2 esophageal cancer patients who underwent MAE (n = 19) and Ivor Lewis procedure (n = 19) were included in this study...
March 16, 2018: World Journal of Surgical Oncology
Krista C J Wink, Erik Roelofs, Charles B Simone, David Dechambre, Alina Santiago, Judith van der Stoep, Wim Dries, Julia Smits, Stephen Avery, Filippo Ammazzalorso, Nicolas Jansen, Urszula Jelen, Timothy Solberg, Dirk de Ruysscher, Esther G C Troost
PURPOSE: To compare dose to organs at risk (OARs) and dose-escalation possibility for 24 stage I non-small cell lung cancer (NSCLC) patients in a ROCOCO (Radiation Oncology Collaborative Comparison) trial. METHODS: For each patient, 3 photon plans [Intensity-modulated radiotherapy (IMRT), volumetric modulated arc therapy (VMAT) and CyberKnife], a double scattered proton (DSP) and an intensity-modulated carbon-ion (IMIT) therapy plan were created. Dose prescription was 60 Gy (equivalent) in 8 fractions...
March 12, 2018: Radiotherapy and Oncology: Journal of the European Society for Therapeutic Radiology and Oncology
Shanila Ahmed, Habib Kibzai, Talha Shahzad, Saulat Hasnain Fatimi, Madiha Bilal Qureshi
Teratomas can be found in different organs of the body and may involve gonads, saccrococcygeal region, mediastinum and other sites. Intrathoracic teratomas always occur in mediastinum and less often arise within the lung. As teratomas mostly involve sex organs (gonads), they rarely occur as extra-gonadal tumors accounting for only 3% of all the cases and very small percentage of such tumors occur in mediastinum.We reported an interesting case of middle aged male who presented to us with symptoms of cough, hemoptysis and trichoptysis (hair expectoration)...
March 2018: Journal of the College of Physicians and Surgeons—Pakistan: JCPSP
Simone B S P Terra, Scott W Aesif, Joseph J Maleszewski, Andrew L Folpe, Jennifer M Boland
Synovial sarcoma (SS), a translocation-associated sarcoma characterized by SS18-SSX1/2 fusion, presents most often in the extremities of young adults. While SS regularly occurs in the pleuropulmonary parenchyma, the mediastinum is an exceedingly rare primary site; the literature on this subject is predominantly composed of case reports and small series, mostly without molecular confirmation. Cases of mediastinal SS were selected from our institutional and consultation archives. Diagnoses were confirmed by either SS18 fluorescence in situ hybridization (n=6) or reverse transcription polymerase chain reaction for SS18-SSX1/2 (n=15)...
March 14, 2018: American Journal of Surgical Pathology
Peter Paik, Sanjay K Arukala, Anupam A Sule
Central venous catheters are placed in approximately five million patients annually in the US. The preferred site of insertion is one with fewer risks and easier access. Although the right internal jugular vein is preferred, on occasion, the left internal jugular may have to be accessed. A patient was admitted for septic shock, cerebrovascular accident, and non-ST-segment elevation myocardial infarction. A central venous line was needed for antibiotic and vasopressor administration. Due to trauma from a fall to the right side and previously failed catheterization attempts at the left subclavian and femoral veins, the left internal jugular vein was accessed...
January 9, 2018: Curēus
Lauren A Bruns, Sarah Isbey, Melisa Tanverdi, Ian Kane
Although there are several reports of intracranial hemorrhage associated with vitamin K deficient bleeding, there are few reported cases of extracranial manifestations, specifically involving the thymus. Here, we discuss the unique case of a 4-week-old infant presenting with scrotal discoloration, respiratory distress, and widened mediastinum, found to have thymic hemorrhage related to confirmed coagulopathy secondary to late-onset vitamin K deficiency bleeding of the newborn.
March 12, 2018: Pediatric Emergency Care
Federica Camela, Marcella Gallucci, Emanuela di Palmo, Salvatore Cazzato, Mario Lima, Giampaolo Ricci, Andrea Pession
The inflammatory myofibroblastic tumor (IMT) is a rare lesion of unclear etiology and variable clinical course, consisting of a proliferation of fibroblasts and myofibroblasts, mixed with inflammatory cells. Synonyms of IMT are inflammatory pseudotumor and plasma cell granuloma reflecting the alleged inflammatory nature attributed to this lesion, even though this heterogeneity in the disease denomination is probably involved in a dispersion of the literature data. Among primary pulmonary neoplasms, it represents the most frequent endobronchial tumor of childhood and beyond the lung it has been described mainly in the bladder, mediastinum and mesentery...
2018: Frontiers in Pediatrics
Calvin Chao, Vijay Vanguri, Karl Uy
First described in 2005, the Mullerian derived cyst in the mediastinum is a rare finding with few subsequent reports. We report a case of Mullerian cyst occurring in the mediastinum of a 49-year-old female that was resected by robot-assisted thoracoscopic surgery. To our knowledge, this is the first report of robot-assisted resection of Hattori's cyst. Histopathologic analysis revealed ciliated Mullerian-type tubal epithelium positive for paired box gene 8 (PAX8), estrogen receptor (ER), and progesterone receptor (PR), confirming Mullerian differentiation...
2018: Case Reports in Pulmonology
Prudence Dy, Cristina Lajom, Josephino Sanchez
Neurogenic tumours of the mediastinum in adults occur most often at the posterior mediastinum, majority of which are benign of nerve sheath in origin. A 72-year-old woman, known asthmatic, presented with chronic symptoms of hoarseness, dysphagia, chest heaviness, easy fatigability, cough, epigastric pain, feeling of abdominal fullness and choking with food intake and at a supine position. Treated for other disorders, routine chest X-ray incidentally found a homogenous convex radiodensity at the right paratracheal area; mass which was also observed with CT and 18F-fludeoxyglucose-positron emission tomography/CT scan studies...
March 13, 2018: BMJ Case Reports
Shuai Liu, Xingzhu Ju, Zheng Feng, Hao Wen, Junyan Xu, Xiaojun Chen, Xiaohua Wu
OBJECTIVE: Our study aimed to explore the prognostic influence of tumor-to-background ratios (TBRs) of the maximum standardized uptake value (SUVmax) in advanced high-grade serous ovarian cancer (HGSC) patients. PATIENTS AND METHODS: We retrospectively investigated 51 advanced HGSC patients who underwent PET/CT before primary surgery at our hospital between January 2010 and June 2015. None of these patients received neoadjuvant chemotherapy. SUVmax of ovarian tumor (SUVmax-P) and background (SUVmax-B) were measured using a PET/CT workstation...
April 2018: Nuclear Medicine Communications
Ahmed Abushahin, Abdulla Zarroug, Magda Wagdi, Ibrahim Janahi
Wheezing and cough are common case scenarios that pediatricians encountered in their office practices. Although a bronchogenic cyst is an uncommon condition, it is essential to be considered in the differential diagnosis of a chronic cough and wheezing among young children who fail to respond to appropriate medical treatment. A 28-month-old girl was referred to our pediatric pulmonology clinic with persistent symptoms of a cough and wheeze unresponsive to standard asthma therapy. This presentation prompted us to undertake a detailed diagnostic evaluation...
2018: Case Reports in Pediatrics
Xiu-Jing Han, Dan-Hong Su, Jian-Yun Yi, Ya-Wei Zou, Yu-Ling Shi
BACKGROUND: The typical manifestations of Penicillium marneffei (nowadays Talaromyces marneffei) infection in children without human immunodeficiency virus (HIV) remain unclear. The current work presents the case of a child without an underlying disease who was infected with P. marneffei comorbid with eosinophilia. CASE PRESENTATION: A 2-year-old male was infected with P. marneffei. A physical examination revealed a high-grade fever, ulcerated lesions in the oral mucosa, anemia, pruritic erythematous papules on the sac and thigh and watery diarrhea...
March 9, 2018: Mycopathologia
Vitor Gabriel Ribeiro Grossi, Karen Lee, Léa Maria Demarchi, Jussara Bianchi Castelli, Vera Demarchi Aiello
Mesothelial/monocytic incidental cardiac excrescences (MICE) are unusual findings during the histological analysis of material from the pericardium, mediastinum, or other tissues collected in open-heart surgery. Despite their somewhat worrisome histological appearance, they show a benign clinical course, and further treatment is virtually never necessary. Hence, the importance of recognizing the entity relays in its differential diagnosis, as an unaware medical pathologist may misinterpret it for a malignant neoplasm...
January 2018: Autopsy & case reports
Fazli Yanik, Yekta Altemur Karamustafaoglu, Yener Yoruk
CONTEXT: Neuroblastoma is the most common extracranial malignant solid tumor that occurs during childhood. It arises from primitive cells and is seen in the adrenal medulla and sympathetic ganglia of the sympathetic nervous system. CASE REPORT: We present a rare case of a 40-year-old man who was diagnosed with the onset of neuroblastoma arising in the mediastinum. He was treated by means of surgical resection in the superior mediastinum after neoadjuvant chemotherapy...
March 5, 2018: São Paulo Medical Journal, Revista Paulista de Medicina
Eve Piekarski, Renata Chequer, Vincent Algalarrondo, Ludivine Eliahou, Besma Mahida, Jonathan Vigne, David Adams, Michel S Slama, Dominique Le Guludec, Francois Rouzet
PURPOSE: Cardiac involvement in familial transthyretin (TTR) amyloidosis is of major prognostic value, and the development of early-diagnostic tools that could trigger the use of new disease-modifying treatments is crucial. The aim of our study was to compare the respective contributions of99m Tc-diphosphonate scintigraphy (DPD, detecting amyloid deposits) and123 I-MIBG (MIBG, assessing cardiac sympathetic denervation) in patients with genetically proven TTR mutation referred for the assessment of cardiac involvement...
March 6, 2018: European Journal of Nuclear Medicine and Molecular Imaging
Dong Keon Yon, Tae Keun Ahn, Dong Eun Shin, Gwang Il Kim, Moon Kyu Kim
BACKGROUND: Germ cell tumors (GCTs) in children are rare neoplasms with diverse pathological findings according to the site and age of presentation. The most common symptoms in children with mediastinal GCTs, which are nonspecific, are dyspnea, chest pain, cough, hemoptysis, vena cava occlusion syndrome, and fatigue/weakness. Because of these nonspecific symptoms, it is difficult to suspect a mediastinal mass. A posterior mediastinal tumor causing spinal cord compression is an important example of an oncologic emergency arising from a neurogenic tumor...
March 5, 2018: BMC Pediatrics
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