The management of Castleman's disease of the mediastinum: a case report

Castleman's disease or angiofollicular lymph node hyperplasia is a rare clinical entity that may present in many sites and with a variety of symptoms. We report here a case of unicentric Castleman's disease (hyaline vascular pattern) located in the mediastinum as a solitary mass. The patient was a Caucasian female 58 years old presented after incidental discovery of the mass in a x-ray. In Castleman's disease surgery is generally recommended for localised lesions to remove the mass as completely as possible reserving other treatment modalities for unresectable cases or multicentric disease

Sarcomatoid lung carcinomas: a case series

We report on three Caucasian Greeks 2 males and 1 female (67, 54 and 62 years old) that were operated with sarcomatoid carcinoma of the lung, an uncommon tumor that sometimes is referred as pleomorphic carcinoma (spindle and giant cell carcinomas). These tumors are encountered in the thorax far more often than true sarcomas. There are many erroneous reports of pulmonary sarcomas made before the advent of adjunctive pathologic screening, including immunohistochemical studies. Pulmonary Sarcomatoid Carcinomas represent 0.2-1% of all lung cancers in different series and they are considered that they are not significantly aggressive than ordinary lung carcinoma

Chilaiditi’s sign or syndrome? Diagnostic question in two patients with concurrent cardiovascular diseases

Chilaiditi’s sign is the asymptomatic, usually incidental radiographic finding, in which a part of the intestine is located between the liver and the diaphragm. The term Chilaiditi syndrome is referred to cases with symptomatic hepatodiaphragmatic interposition. Chilaiditi’s syndrome is usually associated with abdominal or lower thoracic symptoms. We present here the cases of two patients that were admitted with predominantly thoracic  atypical pain. During cardiac work up, it was found that there was a concurrent heart disease for which both patients were managed. Although both patients were treated for the heart disease, a full conservative treatment was implemented, having in mind that Chilaiditi’s syndrome instead of sign could be responsible for the symptoms. Patients’ course was uneventful and they are regularly followed up.  

Simultaneously performed off-pump coronary artery bypass grafting and colectomy: a case report

This is written so as to report the case of a 71-year-old male with a diagnosis of sigmoid adenocarcinoma accompanied by severe coronary artery disease and unstable angina, which was subject to simultaneous surgical treatment. The patient initially underwent an off-pump coronary artery revascularization in order to avoid the complications of cardiopulmonary bypass, providing the opportunity of a colectomy at the same time with the use of safe surgical means. Our case suggests that performing an off-pump bypass procedure prior to cancer surgery can be an appropriate course of action in carefully selected cases

Superior vena cava syndrome in a patient with previous cardiac surgery: what else should we suspect?

<p>Abstract</p> <p>Background</p> <p>Although mediastinal tumors compressing or invading the superior vena cava represent the major causes of the superior vena cava syndrome, benign processes may also be involved in the pathogenesis of this medical emergency. One of the rarest benign causes is a pseudoaneurysm developing in patients previously having heart surgery.</p> <p>Case report</p> <p>We present the case of a large pseudoaneurysm of the ascending aorta, five years after primary surgery, with a significant compression of the right mediastinal venous system causing superior vena cava syndrome, detected at chest CT angiography. Perioperative findings showed two rush out points both coming from the distal aortic suture line which was performed five years ago. The patient underwent reoperation under circulatory arrest facilitating safe exploration and repair of the distal anastomotic leaks</p> <p>Conclusion</p> <p>Enhanced chest CT should be always undertaken in all patients with superior vena cava syndrome, especially in those previously having cardiac or aortic surgery to correctly evaluate the presence of a pseudoaneurysm. Mass effect to the superior vena cava makes necessary an open surgical treatment of the pseudoaneurysm so as to concurrently resolve the right mediastinal venous system's compression. Surgery should be performed in terms of safe approach to avoid exsanguination and cerebral malperfusion.</p

Acute aortic dissection in a young patient without Marfan fibrillinopathy: a case report

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Aneurysmal rib cyst

Thoracic cage is the site of development of various primary or metastatic tumors. An aneurysmal rib cyst is a benign tumor arising from the chest wall. Aneurysmal rib cyst is considered a rare surgical entity and its presence must be followed by removal for histology examination. We present here the case of an aneurysmal rib cyst to a young 33-year-old female. The tumor was presented as an expanding left anterior second rib mass during a self-breast examination. Chest x-ray showed a shadow on the left upper lung area and CT scan revealed a large multicystic mass in the anterolateral left 2nd rib protruding underneath the thoracic major muscle. We discuss the clinicopathological characteristics of this tumor and its surgical management along with a short literature review.   

Clinical significance of positive Raoultella Ornithinolytica and Staphylococcus hominis cultures in a post lobectomy patient. A case report

Raoultella Ornithinolytica (RO) is an encapsulated, Gram- negative, nonmotile aerobic rob which was reclassified from Klepsiella genus belonging in the family of Enterobacteriaceae. It is a rare human infection and few cases have been reported in post thoracotomy patients. Here we present a case of a left lower lobectomy patient that was complicated by pleural effusion and high fever with positive sputum cultures of Raoultella Ornithinolytica and positive pleural fluid cultures of Staphylococcus hominis. It is related with aquatic life poisoning. There are few cases reported and even fewer postoperatively. The infection is rare in human therefore the bacteria is still underreported