Adenocarcinoma in pulmonary sequestration: A case report and literature review.

A 67-year-old male smoker presented with hemoptysis. Chest computed tomography showed an emphysematous cyst and air-fluid levels in the left lower lobe of the lung. A lobectomy was performed. Intraoperatively, the lesion was found to be an intralobar sequestration. Histopathology showed adenocarcinoma within the sequestrated lobe. This case suggests the need for criteria for a thorough diagnostic work-up in patients diagnosed with pulmonary sequestration, to rule out carcinoma as a distinct clinicopathological entity.

Undifferentiated pleiomorphic sarcoma simultaneously occuring with thymoma.

We report here a case of thymoma simultaneously associated with neuroendocrine tumor. A 65-year-old male, presented with cough. Radiographic studies showed a mediastinal mass. On fine needle aspiration cytology and histopathological examination, a diagnosis of thymoma with coexisting undifferentiated pleomorphic sarcoma was made. Although thymoma is associated with many extrathymic malignancies, its association with neuroendocrine tumor is rare. This case is being reported on to reinforce that clinicians should bear in mind the possibility of extrathymic malignancies in patients with thymoma.

Lobectomy after three-dimensional computed tomography of the pulmonary artery.

AIM: Our aim was to evaluate the efficacy of 3-dimensional imaging using multidetector row helical computed tomography for preoperative assessment of the branching pattern of the pulmonary artery before complete video-assisted thoracoscopic lobectomy for lung cancer. METHODS: Forty-nine consecutive patients with clinical stage I lung cancer scheduled for complete video-assisted thoracoscopic lobectomy were evaluated for pulmonary artery branching patterns on 16-channel multidetector row helical computed tomography. Intraoperative finding were compared with the 3-dimensional computed tomography angiography. RESULTS: According to the intraoperative findings, 95.2% (139/146) of pulmonary artery branches were precisely identified on preoperative computed tomography angiography. All of the 7 undetected branches were less than 2 mm in diameter. No patient needed conversion to an open thoracotomy because of intraoperative bleeding. CONCLUSION: Three-dimensional computed tomography angiography clearly revealed individual anatomies of the pulmonary artery and could play an important role in safely facilitating complete video-assisted thoracoscopic lobectomy. However, we were unable to detect several thin branches with this technique.

Surgery for colorectal cancer in the small town of Komotini.

BACKGROUND: Here we report our experience in treating colon cancer in the 5 years from 200 to 2011. Our surgical clinic treated 49 patients with colorectal cancer, of whom 28 (57.14%) were men of mean age 62 years and 21 (42.86%) were women of mean age 66 years. METHODS: In 15 cases, the cancer was related to the rectum (30.61%) and the remaining 34 cases (69.39%) were related to the colon. We found synchronous cancer in two patients. One was found in the blank and the upper right while the second was found in the transverse and sigmoid colon. Six of our patients suffered from coexisting biliary lithiasis and underwent simultaneous cholecystectomy, and simultaneous bile duct exploration for common bile duct lithiasis was performed in one of these patients. RESULTS: Twenty-eight of the patients with colon cancer were treated surgically on an emergency basis. There were two postoperative deaths due to septic shock and multiple organ failure. In total, we noted seven complications, all of which involved patients who had undergone emergency surgery. The length of hospital stay was 8-14 days. Four patients with stage IV disease died 2 years after surgery, and the remainder are still alive. CONCLUSION: We conclude that colon cancer still occurs after the sixth decade, with a male predominance, and is mainly located in the rectum and sigmoid colon. The high rate of ileus in our region indicates inadequate diagnostic access for the residents of our region. However, mortality remains low.

Difficult airway and difficult intubation in postintubation tracheal stenosis: a case report and literature review.

Management of a "difficult airway" remains one of the most relevant and challenging tasks for anesthesiologists and pulmonary physicians. Several conditions, such as inflammation, trauma, tumor, and immunologic and metabolic diseases, are considered responsible for the difficult intubation of a critically ill patient. In this case report we present the case of a 46-year-old male with postintubation tracheal stenosis. We will focus on the method of intubation used, since the patient had a "difficult airway" and had to be intubated immediately because he was in a life-threatening situation. Although technology is of utter importance, clinical examination and history-taking remain invaluable for the appropriate evaluation of the critically ill patient in everyday medical life. Every physician who will be required to perform intubation has to be familiar with the evaluation of the difficult airway and, in the event of the unanticipated difficult airway, to be able to use a wide variety of tools and techniques to avoid complications and fatality.

Abdominal wall endometrioma mimicking an incarcerated hernia: a case report.

The case of a tender, isolated abdominal wall tumor within a Pfannenstiel incision due to a seeding deposit of endometrial tissue secondary to a previous obstetric operation (caesarean section) in a 39-year-old female without previously reported pelvic endometriosis is presented. The lesion clinically mimicked the appearance of an incarcerated incisional hernia at the outer corner of the healed Pfannenstiel incision. The preoperative differential diagnosis also included that of a locally forming post-operative tender granuloma and the remote possibility of an incisional endometrioma (although no link to menstruation could be made). Local malignancy was not taken as a serious possibility. Definitive diagnosis of the excised lesion was made at histology. The pre-operative diagnostic dilemma is presented, along with a short review of the literature.