Pleural Effusion as a Potential Complication of Foreign Body Reaction to Silicone Breast Implants: A Case Study.

Breast augmentation surgery, like any other surgery, has potential complications, including the less common complication of pleural effusion. We present a unique case of a 44-year-old female who developed pleuritic chest pain and shortness of breath 10 days after her breast augmentation surgery, with no prior history of cardiac or autoimmune conditions. The temporal relationship between the surgery and the onset of symptoms suggested a possible direct link to the implants. Imaging showed a small- to moderate-sized left pleural effusion, and pleural fluid analysis revealed findings suggestive of a foreign body reaction (FBR), including evidence of mesothelial and inflammatory cells with a lymphocyte percentage of 44% and monocytes of 30%. The patient received intravenous steroids at a dose of 40 mg every eight hours for three days while hospitalized, followed by a tapered oral dose of steroids upon discharge, for over three weeks. Follow-up imaging studies showed complete resolution of the pleural effusion. The diagnosis of pleural effusion resulting from FBR to silicone gel-filled breast implants involves a clinical history, cytopathological examination, and the exclusion of other potential causes. This case highlights the importance of considering FBR as a potential cause of pleural effusion post-breast augmentation surgery.

A Case of Malignant Brenner Tumor of the Ovary Incidentally Found in a Patient with Deep Vein Thrombosis.

We present the case of a 73-year-old woman who was incidentally found to have a malignant Brenner tumor (MBT) of the ovary during an evaluation for deep vein thrombosis (DVT). The patient presented with swelling in her left leg, non-healing ulcers, weakness, and numbness in her lower limbs. Imaging studies revealed a large multiloculated cystic mass with areas of calcification in the left adnexa extending to the upper abdomen toward the gallbladder fossa. The patient underwent exploratory laparotomy with removal of the ovarian cyst, later diagnosed as a focal MBT in a background of borderline Brenner tumor. Brenner tumors of the ovary are a rare subtype of ovarian neoplasm that accounts for less than 2% of all ovarian tumors. MBTs are even rarer, comprising less than 5% of all Brenner tumors. To our knowledge, this is the first reported case of an MBT incidentally found in a patient with DVT.

Angioleiomyoma of the Hand: A Report of Two Cases.

We present a case series of two rare cases of angioleiomyoma of the hand, an infrequent type of benign tumor. In the first case, a 41-year-old female presented with a left thumb mass that had increased in size over two years. Imaging studies revealed a destructive lesion involving the first webspace with infiltration of the first metacarpal, and the mass was initially suspected to be a sarcoma. However, a percutaneous image-guided fine-needle aspiration (US-FNA) and ultrasound-guided core-needle biopsy (USG-CNB) of the left-hand mass confirmed the diagnosis of angioleiomyoma. The mass was surgically excised, and the final diagnosis was consistent with the earlier USG-CNB. In the second case, a 63-year-old man with end-stage renal disease presented for consultation regarding dialysis access creation. During the examination, a large, soft, mobile mass adjacent to the wrist on the medial aspect of his hand was identified. This was presumed to be a lipoma. However, the histopathology report revealed a benign angioleiomyoma measuring 3.2 cm, which had been completely excised during the surgery. This case report highlights the importance of considering angioleiomyoma in the differential diagnosis of soft tissue masses and the utility of US-FNA and USG-CNB in diagnosing these tumors.

Pulmonary Mycetoma With a Concomitant Reactivation of Pulmonary Tuberculosis Infection: A Case Report and Clinical Pathological Review.

Tuberculosis is a bacterial infection caused by Mycobacterium tuberculosis. It primarily affects the lungs but can also spread to other body parts. One of the possible symptoms of pulmonary tuberculosis (TB) is hemoptysis. In the case of TB, aspergillomas can develop in the cavitary lesions of TB and result in a deteriorating clinical situation. The current case report describes a 63-year-old female previously treated for TB who presented with hemoptysis, fever, and a 4 cm focal density in the right upper lobe on chest X-ray. The patient was found to have concomitant TB and aspergillosis, manifesting as a pulmonary aspergilloma. The co-occurrence of TB and aspergillosis can occur, particularly in patients with weakened immune systems. This case report highlights the importance of considering concomitant TB and pulmonary mycetoma in patients with a history of treated TB who present with pulmonary symptoms.

Posterior Mediastinal Mass: An Uncommon Presentation of a Branchial Cleft Cyst.

Branchial cleft anomalies are a heterogeneous group of congenital disorders that theoretically emerge due to incomplete obliteration of the branchial apparatus, components of the six main pairs of pharyngeal arches, during embryonic development. They can result in a cyst, a sinus, or a fistula. For a congenital lateral neck mass, they represent the most common diagnosis in pediatric neck pathology. Its location is usually in the cervical area, anterior to the sternocleidomastoid muscle. In adults, they present with symptoms such as acute suppurative thyroiditis and recurrent cervical abscess. In this paper, we report the case of a 54-year-old Hispanic woman with a recent history of a left posterior mediastinal mass, detected on computed tomography (CT) scan while studying her recent onset of asthma. The patient underwent an assisted thoracoscopic excision. During the procedure, the mass appeared to be a very large cyst; on histopathological examination, the cyst was determined to be a branchial cleft cyst. To our knowledge, this is the first reported case of this entity located in the posterior mediastinum in an adult patient. Being an unusual and interesting case, it highlights the idea of considering these anomalies when establishing a differential diagnosis of a posterior mediastinal mass.

Neuroendocrine Carcinoma of the Uterine Cervix With Metastases to the Thyroid Gland: A Case Report and Clinical Pathological Review.

Thyroid metastasis from a neuroendocrine carcinoma (NEC) is atypical, and the most common site of origin is the lung. We present the case of a 48-year-old lady with a history of NEC in the uterine cervix, classified initially as a p16-positive high-grade endocervical adenocarcinoma with endometrioid differentiation in a cervical biopsy. The patient, after having a thyroid ultrasound due to thyroid nodules, showing a multinodular goiter and suspicious nodules, and a subsequent fine-needle aspiration with a diagnosis of papillary thyroid carcinoma, presented to our hospital for a total thyroidectomy. Histologically, there were metastatic high-grade carcinoma foci within the thyroid, consistent with metastasis from the cervical primary tumor based on the morphology and immunohistochemical stains, the tumor was re-classified as an NEC. The thyroid gland is an uncommon site for metastasis from primary sites, and a very rare site for an NEC origin; besides, this tumor type is infrequent in the uterine cervix and bears an unfavorable prognosis when present. Therefore, when encountering a high-grade metastatic tumor within the thyroid, an NEC has to be considered in the differential diagnosis for a prompt diagnosis and an appropriate treatment.

Gastric Antral Gastrointestinal Stromal Tumor Presenting With Severe Anemia.

Gastrointestinal stromal tumors are rare gastrointestinal tract growths associated with high rates of malignant transformation. Most cases are asymptomatic and can be identified by computed tomography scan. We present the case of a 50-year-old male with melena and fatigue. Endoscopy showed an ulcerated submucosal tumor diagnosed as a gastrointestinal stromal tumor after surgical resection; it did not present with metastasis and was successfully treated surgically without relapse.

Primary Intraosseous Malignant Peripheral Nerve Sheath Tumor of the Humerus: Report of a Rare Case.

Malignant peripheral nerve sheath tumors (MPNSTs) usually arise in the soft tissues. Intraosseous MPNSTs are rare. They may arise de novo but are typically associated with neurofibromatosis type 1 (NF1) and radiation therapy. Our patient is a 58-year-old female patient that presented with right shoulder pain. An MRI showed a shoulder mass, and percutaneous bone biopsy demonstrated morphology suggestive of an MPNST; besides, on immunohistochemistry, SOX10 was positive, and H3K27me3 expression was entirely lost. The patient underwent total resection of the right proximal humerus and endoprosthetic shoulder reconstruction, followed by radiation therapy and chemotherapy. Only a few cases in the mandible, spine, maxilla, ulna, metacarpal, tarsal, and one in the humerus have been published. In this paper, we contribute with an additional case of primary intraosseous MPNST in the humerus and a brief literature review.