Left Atrial Septal Pouch (LASP) and Cryptogenic Stroke: A Narrative Review.

Over 20% of ischemic strokes are cardioembolic strokes, necessitating research into thrombus formation locations, particularly the left atrial appendage (LAA). The left atrial septal pouch (LASP), which is linked to thrombus development and stasis, has drawn attention recently as a possible thromboembolic location, especially in atrial fibrillation (AF). The primary aim of this review is to explore LASP's role in cryptogenic strokes and to discuss the methods used to assess LAA anatomy. Imaging modalities such as cardiac computed tomography (CT) and transesophageal echocardiography (TEE) are crucial for diagnosing and characterizing LASP. LASP, found in about one-third of individuals, provides an additional site for thrombus development in the left atrium. The potential clinical implications of LASP-related thromboembolic events include the need for targeted therapeutic strategies, such as anticoagulant medication and, in some cases, consideration of LASP closure to prevent recurrent strokes. Further investigation is required to elucidate LASP's involvement in thromboembolic events and to guide stroke prevention in at-risk patients.

A case report of primary hydatidosis of ulna and adjacent soft tissue.

Hydatidosis, is a zoonotic disease prevalent in sheep-raising regions globally. Musculoskeletal hydatidosis is uncommon and usually remains asymptomatic over a long period. The detection of musculoskeletal hydatidosis often signifies extensive cyst spread within the bone marrow cavity, making treatment difficult with a high recurrence rate. Unlike the conventional surgical approach for visceral hydatid cysts, treating osseous hydatidosis requires a strategy akin to oncologic therapy. We report a rare case of primary hydatidosis affecting the ulna and adjacent soft tissue in a 58-year-old woman. She presented with a painless forearm mass evolving over six years, accompanied by recent onset tenderness and restricted elbow joint mobility. Imaging revealed a cystic mass in the forearm, an intra-ulnar bone lesion, and an olecranon fracture. The primary diagnosis of musculoskeletal hydatidosis was made based on clinical findings and radiological imaging. Treatment involved resection of 2/3 of the proximal ulna and pericystectomy for the soft tissue hydatid cyst. Diagnosis of musculoskeletal hydatidosis is vital for effective preoperative planning, as internal fixation often fails without eradicating the infestation. Treatment typically involves radical operation with wide excision of the affected bone and adjacent joint structures, coupled with chemotherapy. Clinicians in endemic regions should consider musculoskeletal hydatidosis in the differential diagnosis of osteolytic lesions and slow-growing cystic masses. Diagnosis relies on clinical, serological, and radiological assessments.

A case report of coexisting multinodular goiter with carotid body tumor.

INTRODUCTION: Carotid body tumor (CBT), a neuroendocrine neoplasm, and benign multinodular goiter (BMNG) are distinct pathologies affecting the neck region. Although rare, they can occur concurrently. This case contributes to the limited evidence regarding the association between these distinct pathologies and their operative management. CASE PRESENTATION: The patient was a 45-year-old female with a palpable mass on the right side of her neck. She was diagnosed with Shamblin type III non-secretory CBT alongside BMNG. The surgical intervention included resection of the CBT, carotid artery bypass, and Dunhill thyroidectomy. DISCUSSION: This case is the third reported instance of coexisting CBT and BMNG. Their causative relationship is evident in the literature without a clear explanation of the underlying mechanism. Both conditions are treated surgically. Dunhill thyroidectomy for BMNG is a safer option, offering more flexibility and advantages over other thyroidectomies. CONCLUSION: This case highlights the complexity of managing such dual pathologies and may provide further evidence of their association.

Recurrent spinal hydatidosis causing Gibbus deformity: Report of a rare case.

Hydatid disease is caused by the larvae of the parasite Echinococcus granulosus and, less commonly, Echinococcus multilocularis in the endemic regions. A hydatid cyst of Echinococcus granulosus commonly develops in the liver and lungs of the affected individual and rarely occurs in the brain, bones, and heart. The spinal hydatidosis comprises 50% of the cases affecting the bones, which usually leads to severe morbidities. We present a case of a 52-year-old Afghan woman presented to the hospital with Gibbus deformity, complaining of lower back pain and flaccid paraplegia for one year. Findings of Magnetic Resonance Imaging of the lumbosacral spine were suggestive of a hydatid cyst involving the vertebrae with extension to the paravertebral soft tissue, leading to acute kyphosis, severe canal stenosis, and cord compression. Treatment included complete cyst removal. The diagnosis was confirmed by gross and microscopic evaluation of the cyst contents. The patient was discharged after significant pain relief and deformity correction. Vertebral hydatidosis is notorious for its recurrence despite vigorous surgical and medical treatment. The hydatid cyst grows rapidly and can cause irreversible damage to the spinal cord in neglected cases. Currently, the best treatment approach is complete surgical removal of the cyst, irrigation with a scolicidal agent, and postoperative follow-up with a long-term course of albendazole. Spinal hydatidosis is a rare, severe disease with significant morbidity. Despite significant scientific advances in understanding of disease pathogenesis, the parasite's predilection for the spine and the influence of host-specific factors on anatomical manifestations remain a mystery.