In patients with uveal melanoma, cardiac metastases can present without any symptoms. It is becoming more common than previously thought and highlights the importance of routine surveillance after definitive treatment.
The primary pancreatic hydatid (echinococcal) cyst is extremely rare with a reported incidence of <1%. Owing to its rareness and a considerable overlap of imaging features, a preoperative diagnosis is usually difficult. The dilemma in confirming this benign diagnosis has often questioned the extent of radical pancreatic resection. The involvement of pancreatic duct (cystopancreatic duct fistula) further complicates the management of such cystic lesions. In this report, we present a case of isolated hydatid cyst of the pancreatic body and tail communicating with the pancreatic duct. Cystogastrostomy preceded by partial cystectomy in the same setting has never been reported to date. The patient had an uneventful postoperative course and follow-up showed no evidence of cyst recurrence or dissemination. We consider this a safe surgical option in longstanding large cysts, especially if a cystopancreatic fistula is detected beforehand. The success of such a procedure however may rely on the size and thickness of the cyst wall to support this anastomosis.
Antiphospholipid syndrome (APS) is an autoimmune disorder characterized by acquired thrombophilia that leads to arterial/venous thrombosis. In patients with APS, stroke, transient ischemic attack, deep vein thrombosis, and pulmonary embolism are the most common thrombotic events. An intracardiac thrombus, a life-threatening complication with a high risk of increased morbidity and mortality, can occur in patients with APS, but it is rare. Still, it is treatable by intensive anticoagulant treatment and or surgical removal. In APS patients, spontaneous intracardiac thrombus formation is a possibility. With a preference for the right ones, however, thrombus formation can occur in all cardiac chambers. On native valves or mural endocardium, thrombus may occur spontaneously or cause by manipulations such as catheter positioning or prosthesis valves. It remains uncertain about the mechanism of thrombus formation. Here we reported 24-year-old lady who presented to the emergency department with shortness of breath and was found to have an intracardiac thrombus in the right atrium. She was admitted to the hospital and received enoxaparin warfarin, which she improved and discharged. In conclusion, while unusual, the probability of right heart thrombus co-existence should be considered in patients with APS who have pulmonary and cardiac symptoms. The prevention and management of
Cutaneous metastasis (carcinoma en cuirasse) is a condition that results from a tumor spreading via lymphatic or vascular embolization, direct implant during surgery or skin involvement by contiguity. Contralateral distant cutaneous breast cancer has never been reported before and hence, the nature and management of such rare cases remains challenging. We aim to present a case of left-sided ‘distant’ cutaneous metastatic invasive duct carcinoma affecting the distal upper extremity (contralateral side) two and half years (disease-free) following treatment for right breast cancer (right mastectomy + chemoradiation). A complete metastatic work-up excluded the presence of any underlying disease. Clinical examination revealed a fungating, irregular ulcer that bled easily on touch involving the left forearm. The ulcer was excised totally and the raw area reconstructed using a split thickness graft. The patient had uneventful postoperative course and now remains disease-free for almost 1 year with no evidence of local recurrence.
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