Thyroid Leiomyoma: Case Report.

37-year-old Colombian male with mass in the anterior region of the neck. Initial ultrasonography and computed tomography (CT) scan showed a large solid mass (67 × 20.7 mm), dependent on the thyroid isthmus. Total thyroidectomy (TT) was performed. The latest pathological and immunohistochemical findings showed a mesenchymal neoplasm compatible with primary thyroid leiomyoma. Supplementary Information: The online version contains supplementary material available at 10.1007/s12070-023-04356-2.

Reliability of radioguided occult lesion localization in reoperation of loco-regional persistent/recurrent differentiated thyroid cancer: Retrospective cohort study.

OBJECTIVES: We aimed to determine the radioguided occult lesion localization (ROLL) reliability in the reoperation of patients with differentiated thyroid cancer (DTC) and persistent or recurrent non-palpable loco-regional disease who underwent surgery at the Instituto Nacional de Cancerología between 2012 and 2021. DESIGN: Observational retrospective cohort study. PARTICIPANTS: We included data from patients with DTC that underwent resection with ROLL. MAIN OUTCOME MEASURES: Reliability analysed as percentage of patients with complete resection of tumour lesion using ROLL, disease-free survival, second loco-regional relapse, adequate resectability and complications. RESULTS: Two hundred and four cases were obtained. Pathological examination revealed papillary thyroid carcinoma in 202 patients, and follicular thyroid carcinoma in 2. Reliability was 96.57% in patients who underwent ROLL. When wide resection was performed-at surgeon's discretion-the reliability increased to 97.5%. CONCLUSIONS: The high reliability obtained suggests that ROLL was effective to localize non-palpable relapsing lesions. To our knowledge, this is the largest sample size published on this topic to date.

Transoral robotic surgery for parapharyngeal carcinoma ex-pleomorphic adenoma: A case report.

BACKGROUND: Carcinoma ex-pleomorphic adenoma (Ca ex-PA) comprises 0.5% of head and neck neoplasms. Transoral robotic surgery (TORS) is an approach being used to treat a variety of benign and malignant head and neck neoplasms. Recently, this technique has gained popularity as an alternative for parapharyngeal space (PPS) tumor resection. To our knowledge, this is the first case of Ca ex-PA managed successfully by TORS of the PPS. CASE: Fifty-nine-year-old male with incidental mass in PPS, initial diagnosis of pleomorphic adenoma, who underwent transoral robotic resection. The histopathology diagnosis with minimally invasive Ca ex-PA findings and malignant component of high-grade epithelial/myoepithelial carcinoma and salivary duct carcinoma. Patient discharged on the fifth post-operative day without complications. CONCLUSION: Based on our findings, TORS may be a safe procedure to remove selected Ca ex-PA from the PPS; however, further research is needed.

Other causes of intestinal obstruction actino-mycetoma - a case report and literature review / Outras causas de obstrução intestinal por actinomicetoma - relato de caso e revisão da literatura

Abstract Introduction: Actinomycosis is a rare infectious disease that affects abdominal organs and simulates oncological disease, hardly ever presents itself as a cause of intestinal obstruction. Symptoms: A 43 years old, male patient with two months of left abdominal pain associated to a growth and an 8 kg weight loss, no fever or bowel habit disruption. Interventions: A colonoscopy and an abdominal scanography. Results: A solid heterogeneous 7 × 3.8 cm mass localized in the splenic flexure of the colon with infiltration of its walls and its surrounding fat. Colon cancer was considered as the first diagnostic possibility. During hospitalization, the patient was taken to an emergency exploratory laparotomy, due to an acute abdominal pain with bowel obstruction symptoms. Histopathological diagnosis: Actinomycetoma. Conjoint continuous monitoring with the infectious disease attending, abdominal US and observation did not show new growths. Weight gain and progressive return to daily life was obtained within 8 weeks. Conclusion: In low income countries, intestinal actinomycosis should be considered in the differential diagnosis of abdominal masses and chronic inflammatory processes, patient prognosis with proper management is excellent.

Resumo Introdução: A actinomicose é uma doença infecciosa rara que acomete órgãos abdominais, simula doença oncológica e dificilmente causa de obstrução intestinal. Sintomas: Paciente do sexo masculino, 43 anos, com quadro de dor abdominal esquerda por dois meses, associado ao surgimento de massa e perda de peso de 8 kg, sem febre ou alterações dos hábitos intestinais. Intervenções: Colonoscopia e uma tomografia computadorizada abdominal. Resultados: Observou-se massa sólida heterogênea de 7 × 3,8 cm localizada na flexão esplênica do cólon, com infiltração de suas paredes e gordura adjacente. Câncer de cólon foi a primeira possibilidade diagnóstica considerada. Durante a internação, o paciente foi submetido a uma laparotomia exploradora de emergência, devido a uma dor abdominal aguda com sintomas de obstrução intestinal. Diagnóstico histopatológico: Actinomicetoma. Monitoramento contínuo em conjunto com o tratamento da infecção, ultrassom abdominal e observação; não foram observados novos crescimentos. Ganho de peso e retorno progressivo à vida diária foram observados por oito semanas. Conclusão: Em países de baixa renda, a actinomicose intestinal deve ser considerada no diagnóstico diferencial de massas abdominais e processos inflamatórios crônicos; com manejo adequado, o prognóstico é excelente.

Uniportal video-assisted thoracoscopic right upper sleeve lobectomy and tracheoplasty in a 10-year-old patient.

Tracheobronchial pediatric tumors are very rare and procedures like pneumonectomy are seldomly indicated due to the associated morbidity. If a surgical approach is considered, the ideal oncological technique would be the minimally invasive sleeve resection, allowing preservation of lung parenchyma (very important in pediatric patients). Here we present the first report of a thoracoscopic right upper tracheo-bronchial sleeve lobectomy in a pediatric patient. A 10-year-old female patient, who received multiple antibiotic treatments for recurrent pneumonia without improvement, was diagnosed with a right upper lobe (RUL) carcinoid tumor. The patient was proposed for uniportal thoracoscopic surgery. The patient was placed in a lateral decubitus position and a single 3 cm incision was performed at the anterior level of 4th intercostal space. A right upper lobectomy with a tracheo-bronchial sleeve resection using the uniportal technique was successfully performed. The postoperative course was uneventful and the patient was discharged home on the 7th postoperative day. The bronchoscopic control showed excellent caliber of the anastomosis with no complications. The uniportal video-assisted thoracoscopic surgery (VATS) approach is an excellent option for endobronchial tumor management in pediatric patients, offering a quick recovery and low morbidity. The performance of a thoracoscopic sleeve anastomosis in young patients is crucial and should only be performed by very experienced thoracoscopic surgeons.

Positive video-assisted thoracoscopic pericardial window management of a right ventricle stab wound with minimally invasive technique.

This is a case report of a successful right ventricle stab wound suture through a video-assisted pericardial thoracoscopic window, avoiding the need of a thoracotomy diminishing its associated risks, morbidity and costs. A 22-year-old patient was admitted to the emergency room with a stab wound on the left side of his chest, the patient showed symptoms of dyspnea and signs of pulmonary hypoventilation on his left lung, a chest tube were placed on the affected side with an improvement on his symptoms. A video-assisted thoracoscopic pericardial window (VATPW) was performed within the next 24 hours to rule out underlying heart wound. A VATPW shows a 1 cm right ventricle wound which was treated through the same portals avoiding a thoracotomy. The left chest tube was removed 48 hours after de procedure and the patient underwent a control echocardiogram, with no abnormalities reported and no symptoms of dyspnea, respiratory distress or palpitation the patient was subsequently discharged. The VATPW is a feasible and safe procedure to rule out underlying heart injury in individualized cases and it provides a minimally invasive treatment option in selected patients avoiding major surgery like thoracotomy or sternotomy and the added morbidity that carry with them.

Características radiológicas de los tumores malignos intracraneales mediante resonancia magnética y espectroscopia en el Instituto Nacional de Enfermedades Neoplásicas, durantye el periodo Setiembre 2008 - Julio 2010 / Hematologic and clinical characteristics before and after the childbirth in patients attended in the National Institute Materno Perinatal 2011

OBJETIVO: Comparar las características hematológicas y clínicas antes y después del parto en pacientes atendidas en el Instituto Nacional Materno Perinatal. MATERIAL Y METODOS: Se realizó una investigación comparativa, con un diseño Prospectivo, transversal. Se analizaron las características hematológicas y clínicas antes y después del parto en 235 pacientes atendidas en el Instituto Nacional Materno Perinatal, El tipo de muestreo fue probabilístico sistemático con arranque cada 3 pacientes. La información se obtuvo de la revisión de historias clínicas, de entrevista con un formulario estructurado y de un examen clínico antes y después del parto. Se procedió a analizar los datos con estadísticas descriptivas medidas de tendencia central, medidas de posición en las variables cuantitativas, distribución de frecuencias en las variables cualitativas, se aplicaron la estadística inferencial t-student en las variables cuantitativas, prueba Chi cuadrado en las variables cualitativas ambas con un nivel significación estadística p=11 g/dL antes del parto (59.57 por ciento) que después del parto (22.98 por ciento). Se con nivel concentración de hemoglobina 10-10.9 g/dL antes del parto (36.17 por ciento) menor que después del parto (38.72 por ciento). se encontró menos casos con nivel de concentración de hemoglobina 7-9.9 g/dL antes del parto(4.26 por ciento) que después del parto (28.51 por ciento) y no se encontró ningún caso con nivel de concentración de hemoglobina <7 g/dL antes del parto en comparación con después el parto ( 9.79 por ciento), el promedio de valor de hematocrito antes del parto (33.2 por ciento ± 2.9) es mayor que el promedio de concentración de hematocrito después del parto (29.2 por ciento ± 3.9). Existe menor presencia de palidez de piel y mucosas antes del parto (40.2 por ciento) que después del parto (26.9 por ciento). Se tiene palidez leve antes del parto (56.8 por ciento) mayor que después del parto (48.7 por ciento).Además se encontró que el promedio de concentración de hemoglobina antes de parto (11.2 g/dL ± 1.2) es mayor que el promedio de concentración de hemoglobina después del parto (9.5 g/dL ± 1.7). CONCLUSION: Se concluye que los valores de las características hematológicas y presencia de características clínicas son mayores antes que después del parto eutócico en pacientes atendidas en e/Instituto Nacional Materno Perinatal