Secretory Meningioma of the Right Frontal Lobe: Clinical Presentation and Pathological Insights.

This article presents a case study of a rare convexity meningioma located in the frontal lobe of the right cerebellar hemisphere. Meningiomas comprise a substantial part of central nervous system neoplasms and are classified into benign, atypical, or anaplastic categories, each encompassing a variety of histological subtypes, among which the secretory meningioma is notably rare. A 77-year-old male presented with a clinical history of headache, impaired memory functions, an initial form of apathetic-abulic syndrome, and a single seizure, which were considered to be indicative of epileptic symptoms that had been present for several weeks. The imaging studies conducted showed a convexity tumor characterized by a rounded morphology and homogeneous contrast enhancement, positioned adjacent to the frontal lobe's cortical surface. This clinical report details the pathology of a secretory type of meningioma, which is distinguished by the atypical epithelial differentiation of meningothelial cells, resulting in hyaline fiber production. The neoplasm's anatomical accessibility permitted successful surgical resection. The tumor's position was appropriate for surgical removal, and the histological variant, along with the patient's favorable clinical course, is of particular scientific interest.

Unusual Presentation of Thoracic Epidural Ewing Sarcoma in a 20-Year-Old Patient: A Case Report.

The aim of this case report is to present a rare case of epidural Ewing sarcoma with spinal cord compression, which is an uncommon presentation of this tumor. Ewing's sarcoma is a primary malignant tumor predominantly affecting individuals in their second decade of life, primarily impacting those aged 10 to 25, with the average age of onset being around 20 years. Epidemiological studies reveal that this cancer most commonly arises in the diaphyses of the long tubular bones in the lower extremities. Spinal involvement, however, is exceedingly uncommon. A case of sacral type of Ewing's sarcoma, with the most common localization of the primary spinal sarcomas and an extremely aggressive course, has been described in the literature. Other localizations of Ewing's sarcoma located in other areas of the spine are also presented. Even rarer are cases in which the tumor formation is located epidurally and exhibits marked medullary compression and absent neurological symptoms. We present the case of a 20-year-old patient who was admitted to the neurology department with symptoms of lower flaccid paraparesis and pelvic-reservoir dysfunction, specifically urinary retention for 16-17 hours, after which a catheter was added. MRI revealed an epidural tumor spanning TH5-TH7 vertebral levels, causing significant spinal cord compression. A CT scan of the chest identified a tumor on the left side at the level of the sixth rib, featuring soft tissue involvement, rib destruction, lung invasion, and a small pleural effusion. Due to the critical neurological symptoms, the patient underwent emergency surgery in the neurosurgical department, which included thoracic laminectomies, maximal possible tumor resection, and effective spinal cord decompression. Postoperative period was uneventful. Histopathological examination confirmed the diagnosis of Ewing's epidural sarcoma. The patient subsequently received adjuvant chemotherapy and radiotherapy. Six months post-treatment, the patient demonstrated a satisfactory overall condition with significant improvement in gait and continues to undergo chemotherapy courses.

Cystic Anomaly Manifestation Within the Axillary Fossa: A Case Report of Clinical Significance.

Ganglion cysts represent a small group of lesions that can arise from almost any joint in the body. Demonstrating a predilection for the joints in the hand and wrist, ganglion cysts in the glenohumeral joint are extremely rare. Due to the vivid array of masses that can be found in the axillary fossa, forming a free-from-error work-up to the correct diagnosis can be quite confounding. In this paper, we present a case of a paralabral cyst of the shoulder joint, located in the axilla. With there being only eight other such cases published in clinical literature, we believe this case report to be of unique importance in gaining further insight into the genesis and treatment of this pathology.

Complications due to ultrasound transthoracic cutting biopsy of peripheral pulmonary lesions and lesions in the chest wall and mediastinum.

INTRODUCTION: Evaluation of patients with peripheral lung lesions and lesions of the chest wall and mediastinum is challenging. The nature of the lesion identified by imaging studies can be determined by histological evaluation of biopsies. An important place in this direction is the ever-increasing popularity among thoracic surgeons of the transthoracic biopsy with a cutting needle under ultrasound control (US-TTCNB).

Unveiling Complexity: Black Pleural Effusion Due to a Pancreaticopleural Fistula.

Black pleural effusions (BPEs) are an exceedingly rare class of exudative effusions of unexplored causality. Their characteristic pitch-black coloring and striking first appearance upon thoracocentesis make them a bewildering occurrence even for seasoned physicians. Forming a free-from-error diagnostic work-up can be arduous and largely depends on thorough history-taking, deliberate imaging studies, and the correct biochemical profile. The upcoming article aims to raise awareness of this pathology by presenting our experience with a BPE after an episode of acute-on-chronic (ACP) pancreatitis and the confounding route to achieving the correct diagnosis and forming the precise therapeutic approach to this scenario. Keeping in mind that this is not a common clinical case, we strive to dispel some misconceptions and thus avoid any subsequent complications and delays in diagnosis when treating this type of effusions and their underlying pathology.

Radical Removal of Low-Differentiation Thymic Squamous Cell Carcinoma: A Rare Clinical Case.

The presented case report demonstrates the successful operative treatment of a patient with thymic carcinoma located in the anterior mediastinum, infiltrating the vena cava, and affecting the upper lobe of the left lung. Our multidisciplinary approach, incorporating various operative techniques, proved effective in treating this type of pathology. The Clinic for Thoracic Surgery at UMHAT Kaspela, Plovdiv admitted a 72-year-old female patient due to complaints related to her cardiovascular and respiratory systems. The patient presented with symptoms such as chest pain, shortness of breath, cough with expectoration, and the presence of blood in her sputum. Additionally, the patient exhibited an increased temperature and experienced shortness of breath at rest. Extensive imaging and diagnostic studies were performed, including computed axial tomography of the chest with contrast material, echocardiography, functional breathing tests, and laboratory tests. The clinical board unanimously agreed that operative treatment was necessary, and the techniques used included robot-assisted surgery and median sternotomy. A low-differentiated carcinoma was identified during the surgical intervention and confirmed through patho-anatomical examination (frozen section) and permanent histological preparation. Immunohistochemical examination revealed that the immunophenotype of the tumor corresponds to thymic neuroplastic squamous cell carcinoma (poorly differentiated). The patient had a smooth postoperative period and was discharged in a satisfactory general condition.

The role of extended resection in locally recurrent colorectal cancer with invasion of the aortoiliac bifurcation: a rare clinical case.

Colorectal carcinoma (CRC) is the third most common cancer and the fourth deadliest. Despite recent advances in screening methods and preoperative imaging techniques, the threat of colorectal cancer remains at an all-time high. Moreover, even after curative treatment, disease recurrence occurs in up to 40% of all cases. However, half of patients with recurrent disease do not register any distant metastases. Therefore, much effort should be expended in identifying and evaluating these patients, as many of them are suitable candidates for en bloc resections with perioperative chemoradiation. In fact, it has recently been found that overall survival benefits greatly from extended resections, provided that free margins are achieved intraoperatively. In this case report, we will present a case of locally advanced recurrent colorectal cancer invading the aortoiliac axis and our approach to achieving a R0 resection.