A case report of pneumomediastinum and subcutaneous emphysema associated with pandemic COVID-19 in a 43-year-old man.

COVID-19 is a newly emerging disease with high mortality among the elderly and patients with underlying medical conditions. We report the case of confirmed COVID-19 infection complicated with pneumomediastinum.

Substernal Mass: A Rare Presentation of Hepatocellular Carcinoma.

A 62-year-old female with a history of hepatitis C presented with one week of worsening abdominal distension. On physical examination, she had icterus, abdominal distension, shifting dullness, and a positive fluid wave. Computed tomography (CT) of the abdomen and pelvis demonstrated a small left hepatic lobe lesion and moderate ascites. Chest CT demonstrated a large substernal mass (3.5 × 1.7 cm) in the anterior mediastinal fat in the region of prepericardial lymph nodes. Following resection of the substernal mass, histopathology revealed metastatic involvement by poorly differentiated hepatocellular carcinoma (HCC). The patient was in fulminant liver failure postoperatively and succumbed to her disease. Mediastinal lymph nodes metastases in HCC are rare and often portend a poor prognosis when present. We discuss a case of HCC presenting with a substernal mass, and provide a literature review of the management and prognosis of lymphatic spread of HCC.

Isolated absence of the right pulmonary artery with coexisting left-sided heart failure: case report and literature review.

Isolated unilateral absence of the pulmonary artery (UAPA) exhibits a benign course and often goes undiagnosed until adulthood. We present a 39-year-old male admitted for left-sided congestive heart failure (CHF) exacerbation. However, chest radiograph demonstrated findings suspicious for UAPA that was ultimately confirmed on computed tomography. Because both CHF and UAPA present similarly with exercise intolerance and dyspnea, a high index of suspicion is required to secure the diagnosis, and in this case, symptoms attributed to CHF may have contributed to delay. A strong awareness of typical radiographic findings allows for initiation of confirmatory tests necessary for a correct diagnosis.

Spontaneous massive hemothorax secondary to chest wall chondrosarcoma: a case report.

We present the case of a 30-year-old man with no past history of disease or recent trauma, who was seen in the emergency room after developing sharp pain in the left hemithorax. Chest roentgenogram showed costopherenic angle blunting and an oval mass in the left mediastinum. A computed tomographic scan showed extrapleural mass with coarse calcifications and pleural effusion, confirmed by magnetic resonance imaging. The tumor was biopsied and removed during thoracotomy. The pathology reported revealed chondrosarcoma, which is a rare cause for a spontaneous massive hemothorax. Invasion of the intercostals vessels by the tumor was the probable cause of hemothorax in this patient.