Primary mediastinal Castleman's disease

Castleman's disease is a rare entity with an unknown etiology which was first described by Castleman in 1954. It is a lymphoproliferative disorder histologically classified into three types; hyaline-vascular, plasma cell type and mixed type. It might be localized or multicentric and usually involves the mediastinum. We report a case of Castleman's disease discovered accidentally in a case of blunt chest trauma which caused a challenging diagnostic process and management

A novel approach in retrieving retained pulmonary bullet injury

Video-assisted thoracoscopic surgery can be a useful tool in selected penetrating chest trauma patients for diagnostic and therapeutic purposes. It is currently a safe and feasible alternative to thoracotomy in the management of chest trauma especially for hemodynamically stable patients.Penetrating chest trauma with retained bullet was removed successfully in a 25 years old patient using double-port VATS technique in combination with fluoroscopy, he made full recovery, hospital stay was very short. Keywords: Fluoroscopy, Penetrating chest trauma, Thoracoscopy, VAT

Unusual cause of solitary pulmonary nodule

Papillary thyroid carcinoma is a common type of differentiated thyroid neoplasms with metastasis mostly described in the literature as occurring in the thyroid gland or in the surrounding cervical lymph nodes. We report a case of a 40-year-old lady who underwent thyroidectomy for papillary thyroid carcinoma 26 years prior to her presentation for solitary pulmonary nodule. Wedge resection of the nodule is consistent with metastatic papillary thyroid carcinoma. Although it is rare to have a remote history and a solitary lesion, it is vital to keep the possibility of metastasis in mind when such a presentation occurs

The Application of Vacuum-Assisted Closure Device in the Management of Empyema Necessitans

Vacuum-assisted closure (VAC) is gaining popularity in the management of many types of acute and chronic wounds. The use of VAC devices in thoracic surgery is limited, but it appears to be promising in complex cases of empyema thoraces. We report a case of empyema necessitans, in which VAC was used to achieve complete wound healing after open drainage which was communicating with the pleural space

A unique presentation of metastatic esophageal adenocarcinoma: The painful thigh

The incidence of esophageal adenocarcinoma is increasing, and with this increase is an influx of unusual presentations in the literature. Skeletal muscles are generally rare as sites of metastasis. We report a case of a middle aged-man who presented with a painful swelling of the thigh which turned out to be consistent with esophageal adenocarcinoma metastasis. Few reports have preceded ours. The prognosis is poor and the therapeutic modalities of such an advanced disease are limited

Management of primary spontaneous pneumothorax: A single-center experience

Background: The prevalence of primary spontaneous pneumothorax is high in the Arab region. There is a lack of studies from the Eastern Province of Saudi Arabia highlighting the associated risk factors and demonstrating the effectiveness of surgical management. Objectives: To identify risk factors associated with primary spontaneous pneumothorax and to correlate the effectiveness of surgical management with the rate of disease recurrence. Subjects and Methods: This retrospective chart review included adult patients who presented with primary spontaneous pneumothorax and were managed at King Fahd Hospital of the University, Al-Khobar, Saudi Arabia, from January 1, 2005, to December 31, 2014. The results are presented as arithmetic mean for quantitative data, and chi-square test was used for statistical analysis. P ≤0.05 was considered statistically significant. Results: In total, 151 patients with primary spontaneous pneumothorax were included, with the majority being male (98.7%) and Saudis (88.7%). The mean age was 24 ± 6 years (range: 13–49 years), mean height 171 ± 8 cm (range: 144–193 cm) and mean body mass index 19.2 ± 3.8 kg/m2 (range: 13.3–39.0 kg/m2). About 62% of the patients were smokers. Ten patients had an ipsilateral recurrence of primary spontaneous pneumothorax after the first episode was successfully managed. Surgical exploration after the first episode itself was found to significantly reduce the recurrence rate. The study found that in the management of these patients, there was a shift from conventional open thoracotomy to the minimally invasive video-assisted thoracoscopic surgery method. Conclusions: The risk factors for primary spontaneous pneumothorax in this study were consistent with the current literature. Surgical exploration after the first episode of primary spontaneous pneumothorax significantly reduces the recurrence rate and there is a paradigm shift toward a less invasive surgical approach in managing these patients

Multiloculated Cavitary Primary Pulmonary Hodgkin Lymphoma: Case Series

Primary pulmonary Hodgkin lymphoma (PPHL) is very rare and typically involves the superior portion of the lung. Pulmonary involvement is observed in 15–40% of Hodgkin lymphoma patients. Three such patients who presented with an unusual form of PPHL in radiological studies, i.e., multiloculated cavitary lesions, were admitted to our hospital. These lesions represent a new pathological and radiological feature of PPHL