ABSTRACT
INTRODUCTION: Pulmonary sequestration is a rare congenital malformation found most frequently as intralobar sequestration in the left lower lobe. Complete surgical resection is considered the treatment of choice. PRESENTATION: We present the case of a 29- year-old woman with intralobar pulmonary sequestration (ILS) diagnosed on chest CT. The sequestration was located in the left lower basal segments (segments 9 and 10) and was treated successfully by robot-assisted segmental resection without complication. DISCUSSION: Recently, robot- assisted thoracoscopic lobar resections started to be performed for ILS. The sublobar, segmental resection are reserved mainly for the resection of pulmonary nodules. We report a first case of robot-assisted anatomical segmental resection for ILS. CONCLUSION: We highlight the role of robotic technology offering three-dimensional view and excellent dexterity enhancing the surgical performance and getting the surgical procedure more precise and safer. This could be useful especially in case of challenging sublobar resections.
ABSTRACT
Thymoma is the most common benign neoplasm of the anterior mediastinum presenting often an agressive behaviour typical for the malignants tumors. The rate of invasive thymoma recurrency is relatively high. We present the case of a 55-year old man with a recurrent invasive thymoma with a pleural dissemination, detected on CT-imaging 2 years following his primary surgery. Since the first pre-operative imaging studies showed no invasion of the adjacent organs and a thymoma was suspected, a surgical resection was decided as a first line treatment. Per-operatively a number of adjacent structures were invaded and despite a macroscopical RO resection, the margins were microscopically positive. An invasive thymoma, WHO classification B3, Masaoka stage IVb was diagnosed and the patient received adjuvant radiotherapy. We highlight the role of multimodality treatement and disscus the potential of surgical, radiotherapeutical and systemic therapy in stage IV thymoma as well as in recurrent disease.
Subject(s)
Disease Management , Pleural Neoplasms/diagnosis , Thymectomy/methods , Thymoma/diagnosis , Thymus Neoplasms/diagnosis , Biopsy , Humans , Male , Middle Aged , Neoplasm Recurrence, Local , Pleural Neoplasms/secondary , Pleural Neoplasms/therapy , Thymoma/secondary , Thymoma/therapy , Thymus Neoplasms/diagnostic imaging , Thymus Neoplasms/therapy , Tomography, X-Ray ComputedABSTRACT
The authors present an account on their experience with treatment of diabetic ketoacidosis with small (physiological) doses of insulin in a group of patients who were hospitalized in the course of four years at the intensive metabolic care unit. Diabetic ketoacidosis is in spite of therapeutic advances still a serious matter. It calls for monitoring of vital functions, intensive treatment and regular checks of laboratory indicators. Treatment of diabetic ketoacidosis with small (physiological) insulin doses proved effective and safe and the incidence of complications was minimal.
