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Background: Haemangiomas are uncommon chest wall tumours arising outside the rib cage. Their occurrence in intercostal muscle is extremely rare. Aim: We describe a case of intercostal muscle cavernous haemangioma as a differential diagnosis for chest wall swelling. Case description: We describe an 18-year-old male patient with an asymptomatic left-sided chest wall swelling. Contrast-enhanced computed tomography revealed a well-defined homogenously non-enhancing mass lesion arising from the seventh intercostal muscle with differential diagnoses of various chest wall tumours. Clinical presentation and imaging findings were inconclusive, but histopathological examination following excision biopsy revealed a cavernous haemangioma. The present case emphasizes the importance of histopathological diagnosis when clinical and radiological examination is inconclusive. Hence, it is necessary to consider intercostal muscle haemangiomas as a differential diagnosis for chest wall tumours in the absence of a feeding vessel. Conclusion: Despite its rare occurrence, intercostal muscle haemangioma must be considered as a differential diagnosis in chest wall tumours even in the absence of a feeding vessel. We believe that histopathology can provide a definitive diagnosis when most investigative procedures are inconclusive.

Hydatidosis is a common zoonotic disease with high prevalence in developing countries. While solitary cyst with unilateral lung involvement is common, bilateral involvement and multiple cysts are rare, seen in 20% and 30% of the cases. Likewise, extensive involvement of extrapulmonary tissues and mediastinum is rare. We report an unusual case of mediastinal hydatidosis mimicking an intrathoracic malignancy in a 24-year-old female. She presented with a history of left-sided chest pain and heaviness in the left hemithorax for a period of two months. Diffuse, multiple fluid-filled cystic lesion with internal echoes throughout the mediastinum, lung, pericardium, diaphragm and chestwall were observed in contrast-enhanced computed tomography of the thorax. An incidental cystic lesion in liver was noted. Since serology for echinococcosis was negative, a differential diagnosis of intrathoracic malignancy was considered. However, intraoperative and histopathologic findings were suggestive of hydatidosis. Keywords: Hydatid cyst; intrathoracic malignancy; computed tomography; magnetic resonance imaging; mediastinum

Background Patients with chronic tuberculous empyema and destroyed lung on a prolonged intercostal tube with failed lung expansion considered unsuitable for single-lung ventilation have poor outcomes. The study's objective was to analyze the surgical outcomes and lung expansion factors in these patients following the open window thoracostomy (OWT) procedure. Methods In a prospective study, patients (males = 63, females = 12) diagnosed with tuberculosis who underwent OWT were analyzed between 2017 and 2018. Factors including age, sex, side, comorbidities, body mass index (BMI), bacteriological culture, and patency of OWT site were evaluated for lung expansion. Results Mean preoperative weight 40.96 ± 5.70 kg increased significantly postoperatively. Pseudomonas aeruginosa (30.66%) was the most typical organism isolated and smoking (21.3%) was the common risk factor. At 6-month follow-up, complete lung expansion was noted in 60% of patients, while partial and no expansion is seen in 17.3% and 22.3% patients. Similarly 82.4% patients with pre-operative BMI>18.5 kg/m2 had complete lung expansion, while with BMI < 18.5 kg/m2, 41.7% and 45.8% had partial and no-expansion. Complete lung expansion was seen in 97.1%, 18.2%, and 23.1% of patients with obliterated OWT, sputum, and pleural pus positive for acid-fast bacilli (active disease), while in 57.9% of patients with comorbidities, complete lung expansion was absent. Conclusion The analysis of various factors concludes that lung expansion is not affected by age, sex, side of the disease, and co-morbid conditions; however, extensively diseased lungs with low BMI and positive bacteriological culture, especially P. aeruginosa, active disease, smoking, and patent OWT, interfered with the expansion of the lung.

Pulmonary aplasia is a rare developmental lung anomaly with unknown etiology. Multiloculated effusion and pericardial defects are even less common with no cases reported up until now. Here, we report the first case of an unusual presentation of a 25-year-old female with recurrent cough for four months, who was diagnosed with left pulmonary aplasia with multiloculated effusion and partial pericardial defects, and who underwent uniportal thoracoscopic drainage and pleurectomy.

Early, aggressive, and minimally invasive approach is an advanced surgical approach for chronic empyema management. The traditional video-assisted technique is considered superior over open thoracotomy for empyema management; however, with further modification, the uniportal video-assisted thoracoscopic surgery (UVATS) has greater advantage for surgeons, providing better anatomical view of target tissues, allowing bimanual instrumentation similar to open approach, and nullifying the creation of dihedral angle by instruments that are not favorable in traditional VATS. The present case series describes different clinical scenarios including chronic empyema secondary to traumatic hemothorax, recurrent tubercular empyema following postoperative open decortication, and methicillin-resistant staphylococcus aureus chronic empyema in pediatric patient, which are effectively managed with UVATS approach.