Medulloblastoma metastasising extraxially is a rare entity. The mechanisms that cause such spread are not fully understood. We present a patient who developed a low thoracic metastasis three years after surgical removal of a posterior fossa medulloblastoma. A spinal metastasis penetrated the dura, thus becoming extradural and from this tumour a completely extradural lumbal metastasis developed. Simultaneous local recurrences of systemic metastases were not noted.
Colonoscopy is a safe procedure and in less than 1% of the patients, colonic perforation may be seen. Physical examination findings such as pain and distension of the abdomen are well-known symptoms however, dyspnea and tachypnea are seen in only a small number of cases as a sign of iatrogenic colon perforation. In this report, we present a 70-year-old female patient with iatrogenic pneumoperitoneum, pneumomediastinum, subcutaneous emphysema and bilateral pneumothorax after diagnostic colonoscopy. The patient was successfully treated with endoscopic colon repair and left tube thoracostomy. When atypical findings are present such as dyspnea and subcutaneous emphysema, iatrogenic pneumothorax, pneumomediastinum should be kept mind after colonoscopy.
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