Giant bleeding post-traumatic thoracic sarcoma management: A case report

The heterogeneity of thoracic wall tumors often represents challenging clinical entities for surgeons due to diagnostic and treatment complexities. The primary tumors, metastases, or direct invasion from intrathoracic structures comprise almost half of all cases on average that are proved to be malignant. Surgery treatment usually leaves large chest defects that require further extensive reconstruction and multimodal management including radiotherapy and chemotherapy. We report a rare case of a giant (30 cm) post-traumatic bleeding thoracic sarcoma treatment in a 70-year-old female. The use of our modified Verneuil technique to close the extensive postoperative skin defect optimized surgical wound management and provided good functional and aesthetic results. Four-year follow-up outcomes after surgical and adjuvant radiation therapy reported a high level of tumor control and showed no evidence of postoperative disease recurrence

Features of radionuclide research after thyroidectomy at the thyroid gland cancer

Aim To clarify the possibility of postoperative radioisotope studies in determining the remnants of thyroid tissue in patients with thyroid carcinoma. Materials and methods The work is based on the study results of surgical treatment and postoperative examination of 120 patients with thyroid cancer, at the Botkin hospital during the period from 2007 to 2013. All patients were performed extrafascial intervention. 118 (98.3%) patients were provided thyroidectomy (including lymph node dissection). For all patients in the postoperative period after 2–4 weeks were performed thyroid and whole-body scan with iodine and technetium, as well as ultrasound and computed tomography of the neck and the chest cavity. Results During the research, 16 (13.3%) patients after scanning with 123I (7 (5.8%) patients), 131I (3 (2.5%) patients), 99mTs-Pertechnetate (6 (5%) patients) and applying them consistently (6 (5%) patients) received the accumulation of the radiopharmaceutical in the operation area, as in the midline in the area of the isthmus, and the locations of the right, left and pyramidal thyroid share. These facts were interpreted as an accumulation of the isotope in the remnants of thyroid tissue after surgery. With additional research methods were revealed swelling and infiltration of tissues in 10 (8.3%) cases in the sterno-hyoid and sterno-thyroid muscles, and in 6 (5%) cases – in the paratracheal and paralaryngeal areas. After fine-needle aspiration biopsy from infiltrative zone was received cytology of nonspecific inflammation. All patients received antiinflammatory and antibiotic therapy with a positive effect. Control ultrasound noted a gradual reduction of the inflammatory infiltrate. After 6 months of thyroid scan was recorded decrease area of uptake, and a year later its complete disappearance. Conclusions Thus, postoperative radionuclide scanning in patients with thyroid gland carcinoma in some cases gives false-positive results, regardless of the type of used radiopharmaceutical