Primary hyperaldostronisim as initial presentation of adrenal cortical carcinoma with liver metastasis: a case report.

Adrenocortical carcinoma (ACC) is a rare tumor and usually a fatal disease which can develop at any age in either sex. Differential diagnosis between malignant and benign adrenal mass is not easy which leads to significant clinical challenge for optimal treatment. Here we report a 22-year-old woman diagnosed with primary hyper aldostronism initially but disease relapsed during six months and magnetic resonance imaging revealed tumor with metastasis to the liver.

A pitfall in the diagnosis of giant bronchogenic cyst presented as loculated pleural effusion.

Being considered as an uncommon congenital anomaly, pulmonary bronchogenic cyst requires surgical treatment due to its rarity and mortality especially in complicated forms. In the present paper, we are presenting a case report of a giant pulmonary bronchogenic cyst (18 cm × 15 cm × 10 cm) misdiagnosed with loculated pleural effusion. Because of unsuccessful treatment of tube thoracostomy, the patient was scheduled for left thoracotomy. Later giant pulmonary cyst was removed completely without any complications. Histopathology studies revealed a giant bronchogenic cyst with abscess formation.

Metastatic medullary thyroid carcinoma: A case report.

Medullary thyroid carcinoma accounts for 4% of thyroid carcinoma and originates from parafollicular cells, secreting calcitonin and carcinoembryonic antigen (CEA). Conventional radiographic modalities such as Computerized Tomography (CT), Magnetic Resonance Imaging (MRI), and Ultrasonography (U/S), are used for detecting recurrences following total thyroidectomy. However, metastatic disease frequently escapes detection by the above modalities, even when its presence is suggested by persistently elevated serum calcitonin levels. In this paper, we report a case of medullary thyroid carcinoma in a 40 year-old woman who had whole body octreotide scintigraphy to evaluate and detect the origin of calcitonin and CEA secretion.

Tako-tsubo cardiomyopathy induced by emotional stress leading to severe mitral regurgitation, cardiogenic shock and cardiopulmonary arrest.

Tako-Tsubo cardiomyopathy (TTC) which is usually precipitated by profound emotional and physical stress has been widely reported in the past. In this case we report a young female patient who developed sudden dyspnea and palpitation after an profound stress (fierce argument).The patient had characteristic feature of progressive pulmonary edema. Her symptom worsened gradually leading to cardiopulmonary arrest in a few hours from the onset. After resuscitation an immediately performed echocardiography showed a severe mitral regurgitation due to rupture of antromedial papillary muscle. Left ventricular function showed akinetic mid-to-distal portion of the left ventricular chamber and hyperkinetic in basal segment. Inotrop infusion and aortic balloon pump placement was done because of unstable homodynamics. Semi-elective surgical valve replacement was performed. One year after the acute event the patient remained asymptomatic. Clinicians should recognize that Tako-Tsubo cardiomyopathy is one etiology of acute pulmonary edema with normal coronary artery finding.