Mediastinal debulking for a T-cell leukaemia/lymphoma presenting with cardiac tamponade.

Anterior mediastinal masses are relatively uncommon and include a wide variety of lesions. Lymphomas account for 25% of anterior mediastinal masses. Lymphomas and other haematological malignancies are associated with pericardial effusion. There are also cases where a cardiac tamponade occurred. The aim of the case reported herein is to discuss the surgical approach and particularly the mediastinal debulking as an adjunct to systematic treatment for haematological diseases presenting as an anterior mediastinal mass responsible for a cardiac tamponade.

Osteoblastoma of the rib: A rare benign tumor with an unusual location.

INTRODUCTION: Osteoblastoma is a rare benign bone tumor commonly located at spine and long bones. However, rib involvement has been reported less frequently. PRESENTATION OF CASE: In this report, we describe a young adult male presenting with left posterolateral chest wall pain. Chest computed tomography showed a calcified tumor in the left third posterior segment of the rib. Radical mass resection was performed and histopathology confirmed a benign osteoblastoma. At last follow-up, 10 months postoperatively, the patient has eventually relieved of the unbearable chest pain. Imaging evaluation revealed no evidence of recurrent tumor. DISCUSSION: Osteoblastoma is an uncommon primary bone tumor accounting for only 1% of all bone tumors. Ribs are involved in less than 5% of patients. The disease has usually good prognosis with a tendency for local destruction and recurrence. CONCLUSION: Radical surgery remains the treatment of choice to prevent recurrences and to provide a definite diagnosis differentiating it from osteoblastoma-like osteosarcoma.

Bartonella quintana endocarditis as a cause of severe aortic insufficiency and heart failure.

We describe the case of a 26-year-old man who developed severe aortic valve insufficiency due to a culturenegative endocarditis, leading to severe heart failure. The diagnosis of Bartonella quintana endocarditis was suspected from the clinical presentation and serological immunofluorescence assay, and was confirmed by polymerase chain reaction analysis of excised valve tissue after aortic valve replacement. The aim of this report is to illustrate B. quintana endocarditis as an important cause of culture-negative endocarditis that presents challenges in its clinical, diagnostic and therapeutic management.

The hybrid stent-graft technique: a solution to complex aortic problems and lessons learned.

OBJECTIVE: The frozen elephant trunk technique has been recently presented in the literature and has been considered as a novel surgical option for single-stage repair of complex aortic pathology such as combined arch and descending thoracic aortic aneurysms. PATIENTS AND METHODS: The first patient, a 74-year-old male, was admitted severely symptomatic (interscapular pain), with aortic distal arch and proximal descending thoracic aortic aneurysm with a diameter of 6 cm. The second patient, a 72-year-old male, underwent descending aortic aneurysm stent grafting one year ago and was admitted gravely symptomatic (interscapular pain), with aortic arch aneurysm (diameter of 5.7 cm) and type I endoleak at the proximal end of the stent. RESULTS: The first patient developed paraplegia after the operation and died three months after the operation due to pneumonia while he was on a rehabilitation program. The second patient's recovery was uneventful and was discharged on postoperative day nine. CONCLUSION: This report summarizes our preliminary experience with this technique emphasizing two points: first, it offers the opportunity to manage efficiently complex aortic problems, and second, there is a potential risk of serious complications related to the limited stent sizes available of the device to match the patient's anatomical characteristics and pathology.