MRI provides several features that contribute to the differentiation between MPNST and non-neurogenic malignant soft-tissue tumors. MRI findings suggestive of MPNST should be helpful to pathologists in the strategy for further examination.

In this literature review prognostic factors and genetic markers that play a role in the staging of thymomas are discussed. The effect on prognosis of different factors, such as paraneoplastic syndromes, age, gender, classification, capsular invasion and surgical treatment, is evaluated. There is no generally accepted pathological classification of thymomas. More recently developed surgical techniques such as video-assisted or robotic thoracic surgery require longer follow-up times to determine whether they have equal long-term results compared to the classical surgical techniques. Many genetic markers have been described but at the present time no definite guidelines can be provided regarding screening and staging of thymomas.

After descriptive analysis, these results can provide strong recommendation of closure of the mesenteric defect and Petersen's space, as we notice a tendency to lower incidence of internal hernias.

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A neonate presented after birth with scrotal and right inguinal ecchymosis. He had been born at term after a difficult vaginal delivery that ultimately required both fundal pressure and vacuum extraction. The thorax was not manipulated during birth. Despite the challenging delivery, the physical examination at birth was normal. A few hours later, however, the child appeared to be in discomfort, with moaning, and was newly noted to have cyanosis. Reexamination revealed ecchymosis of the scrotum and right inguinal region (Panel A). Laboratory results showed a decrease in the hematocrit from 41.2% at birth to 32.5%, normal measures of blood coagulation, and slightly elevated liver enzymes. Ultrasonography revealed three subcapsular lacerations of the liver (in the quadrate lobe and in segments 5 through 7). This case demonstrates an example of Bryant's sign (scrotal ecchymosis) and Stabler's sign (inguinal ecchymosis) caused by retroperitoneal hemorrhage. In this case, the retroperitoneal bleeding was caused by a perinatal liver laceration. The infant required no specific intervention and was discharged home after 1 week, with improvement of the inguinal ecchymosis (Panel B). Follow-up after 1 month revealed no remaining ecchymosis (Panel C).

New-onset MG postthymectomy heralds recurrent disease in 3% of cases. Thorough screening is needed in such patients.

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