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

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

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

Successful management of bilateral refractory chylothorax after double lung transplantation for lymphangioleiomyomatosis

Lymphangioleiomyomatosis (LAM) is a rare disease that leads to airways and lymphatic channels obstruction due to abnormal smooth muscle proliferation. It presents with dyspnea, pneumothorax or chylothorax. Lung transplantation (LT) has emerged as a valuable therapeutic option with limited reports. We report a case of LAM that underwent double LT and complicated by refractory bilateral chylothorax which was managed successfully by povidone-iodine pleurodesis and the addition of sirolimus to the post-transplantation immunosuppressive therapy. The patient has no recurrence with 24 months follow-up

Rare Tumors 2010; volume 2:e11 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. Case Report A 39-year old man presented to the ER with progressive dyspnea and cough for the last si

Substernal Thyroid Masses

A thyroid mass, most often a non toxic colloid goiter or occasionally an adenoma, is not an unusual finding below the level of the thoracic inlet.1 In 1992 Creswell and Wells estimated that these tumors comprise 5.8% of all mediastinal lesions.1 There is no standard definition for thyroid glands extending below the thoracic inlet, but such masses descend from their original cervical location for more than 2 or 3 cm below the thoracic inlet, and are not truly primary tumors of the mediastinum. They preserve the connection between the thoracic and cervical portion and receive their blood supply from the neck.2,3 In 1940, the seminal report of Wakeley and Mulvany divided intrathoracic thyroid masses into 3 types; (1)”Small substernal extension” of a mainly cervical mass, (2) “Partial” intrathoracic, in which the major portion of the mass is situated within the thorax, and (3)”Complete” in which all of the mass lies within the thoracic cavity

Thoracic Surgery Consultations in COVID-19 Critically Ill Patients: Beyond Conservative Approach

Introduction. Iatrogenic pneumothoracis, barotraumas, and tracheoesophageal fistulae, especially after prolonged intubation, and tracheal stenosis are all entities involving thoracic surgeons’ consultation and management. With the surge of COVID-19 cases particularly in the critical care settings, various types of complications have been observed that require intervention from thoracic surgeons. Methods and Materials. A retrospective study was conducted in an academic healthcare institute in the Eastern Province of Saudi Arabia. We included all COVID-19 cases admitted to ICU in the period between March 15, 2020, and August 15, 2020, requiring thoracic surgery consultation and management. Non-COVID-19 critical cases and iatrogenic pneumothorax were excluded. Results. Of 122 patients who were admitted to ICU with COVID-19, 18 patients (14.75%) required thoracic surgery consultation and management. We discovered a significant association between the outcomes and reintubation rates and the rate of pneumothorax occurrence. The survival analysis showed improvement in patients who had thoracostomy tube insertion as a management than the group who were treated conservatively. On the other hand, there was a significant difference between the COVID ICU group who had thoracic complication and those who did not regarding the length of hospital stay. Conclusion. Noniatrogenic pneumothorax, subcutaneous emphysema, and mediastinal emphysema are well-known thoracic entities, but their presence in the context of COVID-19 disease is a harbinger for worse prognosis and outcomes. The presence of pneumothorax may be associated with better prognosis and outcome compared to surgical and mediastinal emphysema

An Electrostatic MEMS Roll-Pitch Rotation Rate Sensor with In-Plane Drive Mode

In this paper, we presented a novel electrostatic Roll/Pitch MEMS gyroscope with in-plane drive mode and out-of-plane sense mode. The proposed structure is developed based on a tuning fork gyroscope with decoupled sense mass on each tine that control the sense out-of-plane frequency. A multi-height deep reactive ion etching (DRIE) fabrication process was utilized to achieve and enhance decoupling between the drive and sense modes. We presented our design methodology followed by an analytical and finite element (FEM) model. Our experimental results showed a good match between the analytical model and those obtained experimentally, from the drive and sense oscillation frequencies. Our characterization setup used a custom made application specific integrated circuit (ASIC) for characterization and was able to achieve ARW of 0.2 deg/rt-h, a bias instability 5.5 deg/h, and scale factor non-linearity (SFNL) 156 ppm FS