Stiff man syndrome with invasive thymic carcinoma

Stiff man syndrome is a rare disease characterized by painful chronic spasms in the muscle and skeletal system. This syndrome is an autoimmune neurologic disorder which is associated with thymoma. We treated a 32-year-old male patient with a type C thymoma [based on the World Health Organization classification] who had stiff man syndrome. The patient underwent an extended thymectomy which brought about alleviation of his symptoms

Results of short- and long-segment cardioesophageal myotomy for achalasia

We report the results of a short- and long-segment cardiomyotomy for relief of the symptoms of achalasia. From 1997 to 2009, 41 patients [22 men, 19 women] with achalasia underwent cardiomyotomy. Patients were divided into 2 groups [short-segment group [SSG] and long-segment group [LSG]]. SSG include 22 patients with laparotomy and 8-cm short-segment myotomy and Dor fundoplication. LSG includes 19 patients with thoracotomy and 12-cm long-segment myotomy and Belsey partial fundoplication. Median follow up was 48 months [range: 12-70 months]. Postoperative dysphagia improved in 20 patients in SSG and in 17 patients in LSG [P < 0.001]. Slow emptying sensation improved in 19 patients in SSG and in 16 patients in LSG postoperatively [P < 0.001]. Heartburn was present in 2 patients in SSG and 3 patients in LSG postoperatively [P = 0.179]. Radiologically, barium stasis decreased significantly from 88% to 25% in SSG and from 85% to 30% in LSG. The lower esophageal sphincter [LES] gradient decreased from 32 to 10 mmHg in SSG and from 34 to 14 mmHg in LSG [P < 0.001]. Short-segment cardiomyotomy reduces the LES gradient and relieves obstructive symptoms

One stage operation for five giant hydatid cysts of both lungs and liver in a 20-year-old female

Echinococcosis remains a significant health hazard in endemic areas, including the Middle East, Mediterranean countries and Central Asia. Pulmonary disease appears more commonly in younger individuals but bilateral pulmonary involvement is relatively rare. Concomitant pulmonary and liver hydatid disease may occur in 4% to 25% of patients with hydatidosis. A previously healthy 20-year-old femal from north of Iran without any previous history of lung or liver disease presented with complaints of right upper quadrant and right side chest pain and a low grade fever for the past one month. In imaging studies, one cyst in the left lung, two cysts in the right lung and two cysts in the liver were found. Since the cysts were symptomatic, it was decided to treat these cysts surgically. The patient underwent bilateral anterolateral thoracotomies and phrenotomy under general anesthesia and all cysts were evacuated. The patient was discharged in good condition

Giant mediastinal thymolipoma in 35-year-old women

The patient was 35-year-old women with a six month history of difficulty breathing and chest pain. An anterior-posterior chest radiograph revealed a widened mediastinum with small lung volumes. During his diagnostic evaluation, a computed tomographic scan was performed and with huge mass in the anterior mediastinum with extension to the left and right side of pleural space. With postero-lateral thoracotomy the huge mass was resected. The patient discharged with good condition

Intralobar pulmonary sequestration with aspergilloma and a large aberrant artery in a 35 year old man

A 35 year old man presented with a 4 month history of cough, hemoptysis, malaise, and fever [>38[degree]C] and moderate [6 kg] weight loss. Investigations with CT scan of the chest revealed a cavitary lesion in the lower lobe of the left lung suggesting the presence of a pulmonary aspergillorna, the remaining lung fields being clear. There was no history of any pulmonary infections. Surgical excision of the affected lobe was performed .During surgical exploration we found that the affected lobe receives its blood supply by a large artery from the thoracic aorta. During follow up his clinical status is excellent

Surgical treatment of chest wall tuberculosis

Tuberculosis remains a formidable challenge to health care providers in developing countries and chest wall tuberculosis is a rare entity .Its clinical presentation may resemble a pyogenic abscess or chest wall tumor. There is still controversy regarding the diagnosis and treatment of chest wall tuberculosis. During a 10-year period [1998-2009], 12 cases with chest wall tuberculosis were managed by our team. Patients' medical records were retrospectively reviewed. After confirming the diagnosis by histopathological examination, patients underwent surgical management. There were 8 male and 4 female patients. Patients' age ranged from 4 to 60 years. Eight patients had a fluctuating abscess and 4 had a chest wall mass. Surgical procedure was drainage along with debridement in 6 patients, wide debridement along with rib resection in 2 patients and wide debridement along with chest wall resection and reconstruction in 4 patients. Recurrence of cold abscess and fistula formation were detected in 2 patients after a follow-up of 1 to 5 years. Outcome of patients with chest wall tuberculosis was good. chest wall tuberculosis mimics symptoms and signs of chest wall tumors or abscesses. The combination of symptoms and radiographic findings suggests the diagnosis of tuberculosis. Wide debridement and resection are shown to have lower rates of fistula formation, sinus formation and recurrence. Medical treatment must be started immediately after surgery