ABSTRACT
INTRODUCTION: Scwhannomas are uncommon neurogenic tumors of the mediastinum. Most of them are located in the posterior mediastinum usually in the paralateral gutters. We report the case of an uncommon localisation of such a tumour appended to the right vagus nerve in the middle mediastinum. CASE REPORT: The patient was 50 years old and complained of thoracic pain, shortness of breath and dysphagia. CT scanning of thorax and abdomen revealed a heterogeneous mass in the middle mediastinum, which was not visible on plain radiography. Further investigation included transoesophageal ultrasound and PET scan. The diagnosis was confirmed by histopathology after mini video-assisted thoracotomy. The schwannoma was entirely removed without any post-surgical complications. CONCLUSION: We report a novel case of schwannoma arising from the vagus nerve and review the diagnostic strategies. PET scanning has poor sensitivity and specificity and does not therefore contribute to confirm the diagnosis which depends on exploring the mediastimun surgically.
Subject(s)
Cranial Nerve Neoplasms/diagnosis , Cranial Nerve Neoplasms/therapy , Neurilemmoma/diagnosis , Neurilemmoma/therapy , Vagus Nerve Diseases/diagnosis , Vagus Nerve Diseases/therapy , Vagus Nerve , Cranial Nerve Neoplasms/pathology , Diagnostic Techniques, Surgical , Humans , Incidental Findings , Male , Middle Aged , Neurilemmoma/pathology , Pancreatitis, Chronic/diagnosis , Pancreatitis, Chronic/diagnostic imaging , Pancreatitis, Chronic/surgery , Radiography, Thoracic , Vagus Nerve/pathology , Vagus Nerve Diseases/pathologyABSTRACT
A triad of signs constitutes Boerhaave syndrome: forceful vomiting, chest pain and subcutaneous emphysema. The syndrome results from spontaneous rupture of the oesophageal wall leading to an oeso-pleural or oeso-mediastinal fistula. Positive diagnosis is established with a water-soluble swallow, sometimes coupled with computed tomography of the thorax. Boerhaave syndrome is a surgical emergency. We report three cases of spontaneous rupture of the oesophagus and analyze the importance of emergency surgery as well as emergency treatment of the sepsis, an important prognosis factor.
Subject(s)
Esophageal Diseases/surgery , Humans , Male , Middle Aged , Rupture, Spontaneous , SyndromeABSTRACT
Pulmonary pseudocysts (PPC) classically relate to chest trauma. It is a rare entity in adults, with multiple differential diagnosis. PPC most often evolve favorably. The clinical diagnosis is difficult to assess due to the poor and non specific clinical data. Chest radiographs are usually unsufficient for the diagnosis and the imaging modality of choice is computed tomography (CT). CT patterns of PPC relate to single or numerous cavities surrounded by air space consolidations. The physiopathological mechanisms of PPC remains uncertain. The histological study of this reported case affords some worth data to highlight the pathogenesis of this acquired abnormality.
Subject(s)
Cysts/etiology , Lung Diseases/etiology , Lung Injury , Accidents, Traffic , Adolescent , Contusions/diagnostic imaging , Contusions/pathology , Cysts/diagnostic imaging , Cysts/pathology , Cysts/physiopathology , Female , Hemorrhage/pathology , Humans , Lung/diagnostic imaging , Lung Diseases/diagnostic imaging , Lung Diseases/pathology , Lung Diseases/physiopathology , Pneumonectomy , Pulmonary Alveoli/pathology , Tomography, X-Ray ComputedABSTRACT
We report two cases of coronary-to-bronchial artery communication responsible for coronary steal. In both cases the anastomosis originated from the proximal circumflex artery and developed because of bronchiectasis. In both cases closure of the anastomosis was achieved successfully by embolization. To date, the patients remained free from symptoms.
