Bursa formation with scapular osteochondroma in hereditary multiple exostosis

Osteochondroma is the most common benign bone tumour present multiple hereditary exostosis [HME]. Scapular osteochondroma associated with pain and bursitis is rarely reported in literature. Here, we describe a 49-year-old male with the diagnosis of HME who was admitted to the Department of Thoracic Surgery with a painful and rapidly enlarging mass behind the left scapula. Computed tomography and magnetic resonance imaging indicated a large bursa formation associated with chest wall mass. Pre-operatively, the mass was diagnosed as osteochondroma and resected. Pathological findings confirmed that mass was a large bursa formation due to scapular osteochondroma without any evidence of malignancy. Osteochondroma should be considered in differential diagnosis of chest wall tumours located at this specific site. We discuss this rare complication of HME and emphasize the importance of early diagnosis and differentiation from malignant transformation of osteochondroma

Penetrating cardiac injuries 10 year experience

To evaluate clinical findings and surgical interventions and their results in the patients referred to our hospital with cardiac injuries. Penetrating heart injury is potentially a life-threatening condition due to cardiac tamponade or exsanguinating hemorrhage. The data of 20 patients undergoing surgical intervention due to penetrating cardiac injury between 2001 and 2010 were retrospectively evaluated. In this series of 20 patients all were male between the ages of 14-65 years, with a mean age of 33.2 +/- 14.15 years. Age interval of the participating patients was between 14 - 65. Eighteen of these patients were diagnosed with right ventricular injuries while two were diagnosed with left ventricular injuries. All the diagnoses were established with clinical examination, direct radiograph, CT, echocardiography and ECG. Four of the patients admitted in emergency service were in agony, four were in shock, and six presented with hypotensive hemodynamic, and four with stable hemodynamic. Right anterior thoracotomy was applied to four patients in agony in the emergency service. Two of these patients died. None of other patients died. All the postoperative patients were followed with echocardiography. Post - pericardiotomy syndrome was detected in one of the patients. Our experience shows that early diagnosis and immediate surgical intervention are the main factors affecting patient survival after penetrating heart injuries. Penetrating cardiac injuries have high mortality. This rate may be 80% in those patients in agony. Emergent intervention in emergency services for the patients under emergent conditions may be life- saving