Follicular thyroid cancer with sternal metastasis - challenges and outcomes

Sternal metastasis from differentiated thyroid carcinoma (DTC) is rare and presents a conundrum for surgeons. We present a lady diagnosed with follicular thyroid carcinoma and sternal metastasis who underwent thyroidectomy, sternectomy and sternoplasty with titanium mesh and acrylic plate. She developed a surgical site infection, of which multiple conservative approaches were attempted. She eventually required removal of the implant. Closure of sternal defect was completed with bilateral pectoralis major advancement flaps. This article highlights a series of complications faced during the course of treatment and how they were managed in a tertiary healthcare centre.

Post ERCP Surgical Emphysema.

Endoscopic Retrograde Cholangio Pancreatography(ERCP) is increasing in popularity due to its obvious advantages. Therefore, as treating physicians and surgeons, we ought to be aware of not only its common but also uncommon complications. We report here a case of post-ERCP surgical emphysema on the right side extending from the umbilicus to the face.

Pulmonary Tuberculosis Presenting as Surgical Emphysema without Pneumothorax and/or Pneumomediastinum

Surgical emphysema as a presenting manifestation of pulmonary tuberculosis in the absence of pneumothorax and/or pneumomediastinum is not yet known. We report one such case in which surgical emphysema was probably the result of rupture of a pulmonary cavity into subcutaneous tissue resulting from caverno-pleuro-cutaneous fistula.