A giant thrombus in the right atrium of a patient with acute promyelocytic leukemia M3.

Acute promyelocytic leukemia is a special type of acute myeloid leukemia. Patients with this disease are at high risk of complications. Right atrial thrombosis is a rare but potentially serious complication. A 55-month-old girl with acute promyelocytic leukemia M3 was in her last phase of treatment. Radiologic examination revealed an echo structure in the right atrium that was still present after 6 weeks of anticoagulation treatment with enoxaparin. Cardiac surgery was performed to remove the mass, which was found to be a calcified thrombus. Although this is a rare occurrence, recognition of the possibility of a calcified thrombus may minimize misdiagnosis and allow surgical retrieval if the thrombus is sufficiently large.

Tracheal reconstruction surgery for congenital tracheal stenosis.

PURPOSE: Congenital tracheal stenosis is a rare but dangerous disease. Reconstructive tracheal surgery is a life-saving treatment but also a challenging procedure. This study aims to evaluate the outcomes of tracheal reconstruction surgery. METHODS: A prospective cohort study was conducted with all the records of congenital tracheal stenosis which had been managed by tracheal reconstruction surgery at Children's Hospital 2 Ho Chi Minh City from August 2013 to August 2022. RESULTS: Sixty-seven cases, who underwent slide tracheoplasty, were included in our study. Mean age was 7.6 months (25 days - 8 years). Common congenital-associated lesion was left pulmonary artery sling, accounting for 65.7% of cases. Bronchial stenosis was found in 22.4% patients. Emergency surgery was performed in eight cases. The survival rate in this review was 86.6%. Nine patients died in which four of nine cases (44.4%) were emergency surgery. The recurrent stenosis rate was 8.9%, only two cases needed reoperation in which one died and one recovered uneventfully. The outcomes of surgery were good in 53 cases (79.1%). CONCLUSION: Tracheal reconstruction surgery with slide tracheoplasty technique is safe and versatile technique which is feasible in every case of congenital tracheal stenosis. Mortality was associated with severe cases which required emergency surgery.

Percutaneous intervention for giant renal extrarenal aneurysm and arteriovenous fistula.

Arteriovenous fistula is a high-flow vascular malformation characterized by a direct connection between an artery and a vein without the presence of a nidus (a network of arterial and venous channels). Renal artery aneurysm concomitant with a renal arteriovenous fistula (RAVF) is extremely rare. We report the case of a 45-year-old woman with a giant renal artery aneurysm combined with RAVF who presented with gross hematuria. The patient was successfully treated by embolization of a giant extrarenal aneurism and RAVF using coils and a plug device. RAVF can lead to harmful complications, and treatment is necessary upon diagnosis. Endovascular embolization is a feasible, efficient, and safe method able to retain maximal normal renal function.