Angiosarcoma is a rare primary tracheal-bronchus origin tumor which was only reported in a few cases. The diagnosis and treatment for such a rare tumor has long been a challenge. In this case, a male hemoptysis patient who was initially misdiagnosed with thyroid carcinoma with tracheal invasion was finally diagnosed with tracheal angiosarcoma. A thick-walled cystic nodular mass was found preoperatively in the right thyroid lobe overlying the tracheal angiosarcoma, which contributed to our initial misdiagnosis. Flap bleeding and necrosis occured after the surgery and patient continued to cough blood even when we excised the whole flap, which suggested the intramural growth and local invasion of the angiosarcoma. This study also reviewed previous literactures on airway angiosarcoma and discussed the treatment strategy.
IntroductionDetermination of pediatric Crohn's disease (CD) remains a major diagnostic challenge. However, the rapidly emerging field of artificial intelligence has demonstrated promise in developing diagnostic models for intractable diseases.MethodsWe propose an artificial neural network model of 8 gene markers identified by 4 classification algorithms based on Gene Expression Omnibus database for diagnostic of pediatric CD.ResultsThe model achieved over 85% accuracy and area under ROC curve value in both training set and testing set for diagnosing pediatric CD. Additionally, immune infiltration analysis was performed to address why these markers can be integrated to develop a diagnostic model.ConclusionThis study supports further clinical facilitation of precise disease diagnosis by integrating genomics and machine learning algorithms in open-access database.
Postoperative benign esophageal anastomotic leakage and stenosis are common complications after esophagectomy. Treatment options for anastomosis stenosis include endoscopic mechanical dilation, dilation-combined steroid injection, incisional therapy, stent placement, and self-bougienage. However, long-segmental cervicothoracic esophageal stenosis and cutaneous fistula are always refractory to conservative treatments and are clinically challenging. When lesions extend well below the thoracic inlet, transthoracic esophagectomy and alimentary canal reconstruction seem to be the common choice but are susceptible to perioperative mortality and donor-site sequelae, especially for patients with poor health conditions. In this report, we present a novel surgical approach for cervicothoracic esophageal stenosis and fistula via partial sternectomy and reconstruction with a pedicled thoracoacromial artery perforator flap. No recurrence or complications occurred throughout 3 months of follow-up. This case study adds new perspectives to the treatment of anastomotic stenosis.
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