A poor prognosis of a mediastinal bronchogenic cyst with malignant transformation: A case report.

INTRODUCTION: Bronchogenic cysts (BC) are congenital lesions, it results from an abnormal budding of the tracheobronchial tree. Malignant transformation is very rare. We report a case of adenocarcinoma arising in a BC of the posterior mediastinum detected after surgery. PRESENTATION OF CASE: We report the case of a 32-year-old man, without a particular medical history. The patient presented a cough associated with dyspnea, and a weight loss 4-month before the diagnosis. The imaging tools, showed a voluminous latero-tracheal mass of the posterior mediastinum. The diagnoses of a neurogenic tumor or a BC were suspected. The patient was treated by video-assisted thoracoscopy. Complete excision was done complicated by lesion's small rupture. The microscopic exam revealed unfortunately an adenocarcinoma arising in a BC. The patient had started the cure of chemotherapy. Six months later, the patient died due to tumor recurrence with cerebral metastasis. DISCUSSION: Mediastinum BC, is usually located within the middle and posterior mediastinum. This condition is a benign congenital lesion. His curative therapy was a complete surgical resection with a good prognosis. However, malignant transformation may seldom occur and is most often accidentally diagnosed during the histological examination of specimens. In this case, the surgical treatment may be insufficient, and the prognosis may be poor. CONCLUSION: Malignant degeneration of mediastinal BC, despite being rare, should be kept in mind, carefully avoided and managed.

Thoracoscopic retrieval of an intrapulmonary sewing needle: A case report.

The intrathoracic sewing needle is an exceedingly rare condition mildly documented in the literature. Given the needle's tendency to migrate, it must be removed as soon as possible, and the minimally invasive technique should be tried first.

Bilateral pulmonary hydatidosis associated with uncommon muscular localization.

INTRODUCTION: The lung is the second most commonly affected organ by hydatidosis, and the bilateral involvement is rare even in endemic regions. CASE PRESENTATION: We report the case of a 27-year-old patient who presented with right basithoracic pain and cough evolving for three months. Thoracic CT scan revealed two homogeneous, rounded cystic formations enhancing after injection of the contrast media, located in the lateral basal segments of the lower lobe. An abdominal CT scan was performed to rule out a hepatic localization of the hydatid cyst, revealed a cystic formation of the left psoas muscle. The diagnosis of bilateral hydatid lung cyst associated with hydatid psoas muscle location was then made. The patient underwent a two-stage thoracic surgery. The second step involved partial cystectomy of the psoas muscle hydatid cyst via a left iliac incision and using an extraperitoneal approach. The postoperative course was uneventful. DISCUSSION: Management of bilateral pulmonary hydatid cyst is controversial. Some authors recommend operating bilateral cysts in two-stage surgery, with an interval of three to four weeks between procedures. The involvement of the psoas muscle is rare and is generally secondary to the rupture of splenic, hepatic or renal hydatid cysts. Generally, its diagnosis is delayed as the latter is most of the time asymptomatic. CONCLUSION: Bilateral pulmonary hydatidosis associated with hydatid cyst of the psoas muscle is a rare entity. Radiological investigations and especially CT scan are the mainstay of diagnosis. Surgery remains to be the treatment modality of choice.

Gigantic Mediastino-Abdominal Hydatic Cyst Through Esophageal Hiatus.

Hydatid disease is one of the most widespread and endemic infections causing a substantial health and economic burden. The liver and lungs remain the most affected viscera. We report the case of a 41-year-old man with an atypical presentation: a hydatid cyst of the liver with a massive extension to the mediastinum through the esophagus hiatus. This patient underwent a single-stage surgical session to treat the mediastinal and abdominal parts of the cyst through a unique thoracic route.

Penetrating injury of the ascending aorta complicating a sternal biopsy.

Bone marrow aspiration and trephine biopsy are considered safe procedures. Some serious but rare adverse events directly attributable to these procedures have been related in a few reports in the literature. We report a rare case of ascending aortic injury following a sternal trephine biopsy.