A Large Pleural Solitary Fibrous Tumor Successfully Resected Using Uniportal Video-Assisted Thoracoscopic Surgery.

Solitary fibrous tumors (SFTs) are rare neoplasms arising from submesothelial connective tissue. Typically affecting elderly individuals, SFTs can exhibit malignant characteristics despite most cases being benign. Diagnosis often occurs incidentally on routine chest radiographs, and patients are usually asymptomatic unless the tumor causes compression of adjacent structures. While imaging studies aid in identification, confirmation of the diagnosis requires bronchoscopy with tissue sampling and immunohistochemistry. Surgical excision remains the primary treatment for SFTs, with complete resection being associated with a better prognosis. Our case highlights the successful management of a massive SFT using uniportal video-assisted thoracoscopic surgery (VATS). Regular chest computed tomography (CT) follow-up is important for monitoring SFTs and ensuring timely intervention when necessary. We present the case of a 54-year-old female with a massive SFT presenting as a pleural tumor in the right lower lobe. The patient was initially asymptomatic, and the diagnosis was made incidentally during routine chest CT follow-up. Uniportal VATS was successfully performed for the excision of the tumor measuring 10x9x6 cm. Our case highlights the successful application of uniportal VATS for the thoracoscopic removal of a huge pleural solitary fibrous tumor.

Rheumatoid Arthritis With Focal Segmental Glomerulosclerosis: A Case Report and Literature Review.

Rheumatoid arthritis (RA) is a chronic systemic autoimmune disease primarily affecting the joints and, to a lesser extent, other systems. Renal involvement in RA is rare and might be due to the presence of systemic inflammation or the toxic effect of the medications used. Of the many types of renal diseases that can affect RA patients, focal segmental glomerulosclerosis (FSGS) is rarely encountered. In this report, we present a rare co-existence of RA and FSGS in a 50-year-old female with RA who was found to have FSGS as a possible cause of proteinuria and an extraarticular manifestation of RA. The patient's RA started as palindromic rheumatism, which progressed later to chronic symmetrical polyarthritis of the small and large joints. Along with the flare of her joint disease, she was found to have lower limb edema. Her workup showed persistent proteinuria of more than one gram per day. Renal biopsy showed unexpected findings of FSGS. Our patient was treated with tapering doses of steroids, methotrexate, candesartan, and a diuretic that controlled joint disease, blood pressure, and proteinuria. Follow-up at two years showed normal kidney function tests, a significant decline in proteinuria, and controlled joint disease. Our case portrays a possible relationship between FSGS as a cause of proteinuria in patients with RA. Physicians should be aware of the possibility of FSGS in RA patients, which can affect the management plan, medication efficacy, and overall prognosis.

Isolated Wrist Drop as the Sole Presentation of an Acute Embolic Ischemic Stroke.

Stroke is a major public health concern and a leading cause of morbidity and mortality worldwide. It often presents with a wide range of neurological deficits based on the neuroanatomical locus of the insult. Symptoms widely vary and usually occur in concordance with the distribution of the homunculus. Although rare, stroke can present with isolated wrist drop, which creates a diagnostic dilemma owing to the fact that this condition is by far more commonly caused by peripheral lesions. Moreover, localizing the site of injury is crucial for guiding therapeutic management and determining the overall prognosis of the condition. We present a 73-year-old patient with an isolated central wrist drop caused by an embolic ischemic stroke that was initially confused for a lower motor neuron pathology affecting the radial nerve.