Wide en-bloc thymectomy and venous axis reconstruction in Masaoka stage IIIB thymoma: a case report and literature review.

Thymomas are rare tumors originating from thymic tissue and rarely metastasize. They can be diagnosed either incidentally or symptomatically when compressing or invading nearby structure. A 36-year-old man presented with significant high-grade fever, chest pain that worsens upon lying down, and dyspnea. A chest X-Ray and computed tomography followed by biopsy confirmed the diagnosis of thymoma. The management included chemotherapy cycles, followed by surgery. Pericardiectomy was performed with en-bloc thymectomy and partial resection of the infiltrating lung. Venous drainage was restored by 8/16 mm inverted bifurcated brachiocephalic-superior vena cava Dacron bypass. The pericardium was reconstructed by a synthetic Dacron patch, and the right diaphragm metastasis was resected. Neoadjuvant chemotherapy was initiated. After 3 months of follow-up, no recurrence was evidenced by computed tomography.

Primary pituitary abscess with atypical imaging features: A rare case report.

INTRODUCTION AND IMPORTANCE: A pituitary abscess (PA) is an extremely rare disease. It is characterized by the presence of an infected purulent collection within the Sella turcica. PAs are categorized in two categories: primary, when the pituitary is normal before the infection, or secondary, when there is a pre-existing sellar pathology (e.g., pituitary adenoma, Rathke's cleft cysts, or craniopharyngioma), meningitis, paranasal sinusitis, or head surgery, which may be indicative of the source of infection. CASE PRESENTATION: We presented a case of a 52-year-old male with visual disturbances. Both a computerized tomography scan and magnetic resonance imaging revealed a sellar mass lesion, initially suspected to be a pituitary tumor. During transsphenoidal surgery for excision of the pituitary mass, an amount of pus was drained, indicating a pituitary abscess, which was confirmed by positive Staphylococcus aureus colonies in the culture. After surgery, the patient received antibiotic treatment for 12 weeks. After two years of follow-up, the patient remained free of complications and did not require hormone replacement therapy. CLINICAL DISCUSSION: In previous research, there were a total of 488 patients, of those, 318 were primary pituitary abscess. Preoperative diagnosis is still difficult due to a combination of nonspecific symptoms and imaging findings. Endonasal trans-sphenoidal pus evacuation, culture, and individualized antibiotic therapy are available treatment options. CONCLUSION: Pituitary abscess is a rare illness, but it should always be considered when evaluating a patient with a fast visual decline. Following the diagnosis, surgery and antibiotics should be started immediately. Proper therapy usually yields a positive effect.

A massive primary congenital mesoblastic nephroma was successfully managed through open total nephrectomy: a case report.

Background: Congenital mesoblastic nephroma is the most common renal tumor in children under the age of 6 months, comprising 3-10% of all kidney tumors in children. It is a rare and mostly benign tumor. It divides into cellular, classic, and mixed subtypes. It is typically detected in the third trimester of pregnancy using ultrasonography and magnetic resonance imaging. The best treatment is surgically by completely removing the tumor. Case presentation: We reported a case of a one-day-old female who was born at 31 weeks gestation weighing 1670 g. Preterm labor was due to polyhydramnios, which was diagnosed predelivery. A large mass was detected in the left hypochondrium using computerized tomography, total nephrectomy was performed, and the histopathological examination of the specimen confirmed the diagnosis of congenital mesoblastic nephroma. Clinical discussion and conclusion: Early polyhydramnios could be the most significant sign of renal tumors in infants, especially congenital mesoblastic nephroma.

Systemic sclerosis sine scleroderma with atypical clinical course: a rare case report.

Introduction and importance: Systemic sclerosis (SSc) is divided into three subtypes: limited cutaneous SSc (lcSSc), diffuse cutaneous SSc (dcSSc), and systemic sclerosis sine scleroderma (ssSSc). ssSSc is a rare subtype of SSc that presents with internal organ manifestations but no cutaneous findings. Case presentation: We report the case of a 58-year-old patient with a history of pulmonary hypertension who presented with symptoms of fatigue, inflammatory polyarthritis, and joint swelling. Following a comprehensive clinical examination and laboratory tests, the patient was diagnosed with ssSSc. Clinical discussion: Due to its atypical clinical course, we present this case report, which commenced with idiopathic pulmonary hypertension. Subsequently, after 7 months, the patient presented complaints of polyarthritis with positive antinuclear antibodies. Raynaud's phenomenon was identified 2 months later during the rheumatology clinic examination. Typically, the clinical course encompasses all three features simultaneously, without any gap between them. Conclusion: Diagnosis of ssSSc remains challenging, and it is essential to consider this disease form in all cases involving unexplained fibrotic involvement of the internal organs.

A massive primary hydatid splenic cyst was successfully managed through open total splenectomy: a case report and review article.

Background: Cystic echinococcosis (CE) is a parasitic infection that is caused by the tapeworm Echinococcus granulosus. CE is very common, especially in the rural areas of developing countries. The most commonly affected organs by hydatid cysts are the liver and the lungs. However, the primary splenic hydatid cyst (PSHC) is a very rare manifestation of CE with an incidence of 0.5-8%. Case presentation: A 17-year-old female patient presented with abdominal pain which gradually increased over months, along with anorexia and vomiting. Computerized tomography showed a massive splenic cystic mass. An open total splenectomy was performed. By follow-up, the platelet count and a postoperative chest X-ray were normal. The patient was prescribed Albendazole and analgesics. The pathological study confirmed the diagnosis of PSHC. Conclusion: Despite the occurrence of PSHC being very rare, it is very important to take it into consideration, especially in endemic areas.

A unilateral twin ectopic pregnancy in the fallopian tube: A rare case report.

INTRODUCTION: The implantation of a fertilized ovum outside of the normal uterine cavity is referred to as ectopic pregnancy, most frequently in the fallopian tube. Unilateral tubal twins are a rare diagnosis since they occur in around 1 in 125,000 spontaneous pregnancies. PRESENTATION OF CASE: We report a case of A 39 -year- old female (Gravida 6, para 6) who presented to the emergency department with continuous abdominal pain and with vaginal bleeding, Transvaginal Ultrasound,and positive hCG levels suggested having an ectopic pregnancy that was managed by surgical laparotomy that revealed a twin ectopic pregnancy. DISCUSSION: By using transvaginal ultrasound and urine/serum beta-human chorionic gonadotropin (bHCG) tests, early ectopic pregnancy identification has improved, reducing related morbidity and death. In our case, a gestational sac was detected during a vaginal ultrasound and the high level of bHCG (63,000) suggested an ectopic pregnancy. Surgical management was chosen because the pregnant sac was on the verge of bursting. CONCLUSION: This case serves as a reminder of the importance of considering the potential for having twin ectopic pregnancies.