Management of a Unique Subcarinal Bronchogenic Cyst with Robotic-Assisted Thoracic Surgery.

A bronchogenic cyst (BC), although a rare congenital abnormality, represents the most common cystic lesion in the mediastinum and can present with chest pain and shortness of breath, especially due to compression of adjacent vital structures. The most common diagnostic modalities used are computed tomography (CT) and magnetic resonance imaging (MRI). These cysts may elude even a seasoned clinician unless they become symptomatic. For clinicians attempting to give optimum and prompt management for these cysts, robotic-assisted surgical resection is the recommended treatment of choice. Robotic-assisted thoracic surgery (RATS) offers precision and enhanced visualization, making it a safe and accurate approach for the removal of posterior mediastinal BCs. Our patient is a 65-year-old female who presented with symptomatic posterior mediastinal subcarinal BCs and underwent complete surgical resection with RATS. The diagnosis was confirmed with histopathology. Advancements and the clinical impact of RATS for mediastinal BCs including the Da Vinci robotic surgeries have been demonstrated to be minimally invasive, safe, and feasible especially when in difficult-to-reach areas. RATS has also proven to be advantageous in reducing disease burden and improving patient outcomes.

A Case of a Constricted Vessel: The Impact of Acute Myeloid Leukemia on the Superior Vena Cava.

Acute myeloid leukemia (AML) is the most prevalent form of leukemia in adults, with rising global incidence rates. AML usually presents with non-specific clinical features such as pallor, fever, and bleeding. This case report discusses a unique presentation of AML, where a 25-year-old female with a history of hypertension presented with unilateral facial swelling, chest pain, and shortness of breath. Radiologic investigations revealed a mediastinal mass encasing the superior vena cava (SVC), confirming the suspicion of SVC syndrome. Upon testing with a biopsy, the mass was found to be composed of immature myeloid cells confirming the diagnosis of myeloid sarcoma-associated AML. The patient's treatment involved a combination of surgical debridement, induction chemotherapy, supportive care, and management of complications. This case highlights that despite its common occurrence, AML may present with atypical clinical manifestations such as SVC syndrome, posing challenges in its diagnosis and timely management.