A giant mediastinal thymolipoma: a rare pathological entity.

Thymolipoma is a rarely seen benign pathological entity of anterior mediastinum and constitutes of around 2-7% of thymic tumors. They usually present as soft tissue mass composed of mature adipose tissue and thymic tissue, which are clinically silent most of the time, i.e., the reason they reach to a larger dimension before diagnosis. Preoperaative diagnosis is always challenging for the thymolipoma. We wish to report a case of the soft tissue mass of anterior mediastinum in a young male, which on surgical exploration and final histopathological examination was diagnosed as thymolipoma.

Feasibility, Safety, and Surgical Outcome of Robotic Hemithyroidectomy Via Transaxillary and Retroauricular Approach: an Institutional Experience.

The aim of this observational prospective study was to determine the technical feasibility, safety, and adequacy of robotic hemithyroidectomy. From April 2015 to May 2016, 16 patients with solitary thyroid lesion underwent robotic hemithyroidectomy using the Da Vinci® Si Surgical system. Patients were observed and data were recorded on surgical time, blood loss, complications, and functional outcome of the patients. A total of 16 patients (3 males and 13 females; mean age 39.9 years) underwent robotic hemithyroidectomy after evaluation for solitary thyroid nodule with a mean nodule size of 2.2 ± 0.3 cm. Fiber-optic laryngoscopy (FOL) was normal in all cases pre-operatively. Five patients were operated by transaxillary approach, the rest by retroauricular (facelift) approach. Mean pocket dissection time was 42 min for transaxillary and 40 min for retroauricular approach. Mean operative console time was 59.4 min for transaxillary and 52.6 min for retroauricular approach. Average blood loss was 45 ml. Mean hospital stay was 1.5 days. None of the patients had any post-operative complication on follow-up. One patient had restricted left vocal cord mobility which improved in 3 months. Mean pain score was 0.25 ± 0.4 and average speech score was 0.5 ± 0.2 at 3 months. Post-operatively, all patients had adequate swallowing with no episode of aspiration. Robotic hemithyroidectomy is a safe, feasible, and oncologically safe procedure. It has benefits in terms of better scar cosmesis than open surgery.

Survival benefits of adjuvant radiation in the management of early tongue cancer with depth of invasion as the indication.

BACKGROUND: With the introduction of new American Joint Committee on Cancer (AJCC) classifications for head and neck cancers few cases are upgraded from T2 to T3 based only on depth of invasion. The role of adjuvant therapy in this particular subset of patients is still not defined. METHODS: This is a retrospective analysis of data from 2009 to 2015, of patients with histopathology of pT1, T2, and N0. A total of 375 patients were subdivided into 3 groups per the new AJCC classification depth of invasion <5 mm, 6 to 10 mm, and >10 mm. Survival analyses of patients receiving adjuvant therapy and those who did not were compared with specific emphasis on patients who were upstaged from T2 to T3 based on depth of invasion. RESULTS: Depth of invasion is a poor prognostic factor and addition of adjuvant therapy based on depth of invasion did not have significant survival benefits. CONCLUSION: Addition of adjuvant therapy based on depth of invasion does not influence survival in patients with early carcinoma of the tongue.

Mediastinal Teratoma with Pulmonary Parenchyma Fistula: A Rare Diagnostic Endeavour.

Teratoma is the most frequent mediastinal germ cell tumour amongst young population. They are often detected due to pressure symptoms or as an incidental finding on chest X-ray done for any other reason. Mediastinal teratoma is usually benign and rarely possesses diagnostic or therapeutic challenge unless they rupture into surrounding viscera. In such scenario, they may lead to acute life threatening condition and need prompt diagnosis and surgical extirpation. Here, we are reporting our experience of managing a young lady, who presented with short duration breathing difficulty and cough, and was diagnosed with ruptured mediastinal teratoma on imaging, which was further confirmed intraoperatively and histopathologically.