Ibrahim Can Kurkcuoglu

Co-occurrence of diaphragmatic and serratus anterior muscle hydatidosis: an unusual localization.

BACKGROUND With hydatid cyst, the skeletal muscles and diaphragm are rarely affected, and hepatic and pulmonary hydatid cysts are far more common. We report a case with an unusual localization of diaphragmatic and serratus muscle anterior hydatidosis that occurred simultaneously. CASE REPORT A 37-year-old developmentally disabled woman presented to the Emergency Department (ED) of Harran University with tachycardia, tachypnea, and dyspnea. On pulmonary auscultation, breath sounds were decreased on the right side. A chest X-ray study revealed a radiopaque right hemithorax with a mediastinal shift and tracheal displacement. Thoracic computed tomography scan revealed a hydatid cyst in the serratus muscle anterior and cystic vesicles in the pleural cavity. The patient underwent chest drainage. During drainage, daughter vesicles within the pus were detected macroscopically. An elective thoracotomy was performed after hemodynamic stabilization of the patient. Postoperative chest X-ray study demonstrated that the lungs had re-expanded. The patient had no postoperative complications and was discharged with relief of all symptoms. CONCLUSION Hydatid cyst should be considered, especially in endemic regions, in the differential diagnosis in the presence of a rare localization or unexpected clinical presentation. Surgical intervention is the appropriate approach for the treatment of hydatid cyst when there is concomitant intrathoracic involvement.

Our Experiences with Chest Trauma Patients in Syrian Civil War

DOI: 10.4328/JCAM.2247 Received: 24.12.2014 Accepted: 05.02.2014 Printed: 01.09.2015 J Clin Anal Med 2015;6(5): 573-5 Corresponding Author: Şamil Günay, Harran Üniversitesi Tıp Fakültesi Göğüs Cerrahisi AD. Şanlıurfa, Türkiye. T.: +90 4143183352 GSM: +905336472915 F.: +90 4143183389 E-Mail: samilgunay@yahoo.com Özet Amaç: Toraks cerrahisi, savaşta etkinliği tartışılamayacak kadar değerli bir branştır. Komşumuz Suriye’deki iç savaş sırasında bölgemiz göğüs cerrahi uzmanları bu etkinliği çok yakından hissetmişlerdir. Biz de, bu bölgeden sevk edilen hastalardaki deneyimlerimizi aktarmak istedik. Gereç ve Yöntem: Olgularımız Ağustos 2012Kasım 2013 tarihleri arası Suriye’den ateşli silah yaralanması sonrası getirilen 16-75 yaş arası, 33 erkek 8 kadın 41 hastadan oluşmaktaydı. Bulgular: İzole toraks travmalı 11 hastanın dışında, 9 hastada toraks ve batın (% 21.9), 8 hastada toraks ve ekstremite (% 19.5), 3 hastada toraks ve vertebra (% 7.3), 5 hastada toraks, batın ve kranium (% 12.1), bir hastada toraks, batın ve göz (%2.4), 3 hastada toraks, batın ve vertebra (%7.3), bir hastada toraks, batın ve ekstremite (% 2.4) yaralanması tespit edildi. Tartışma: Göğüs cerrahisi, savaş esnasındaki yaralanmalarda hızlı ve etkin müdahele edilebilirse hayat kurtarıcı bir branştır.

Surgical management of an inoperable giant pleomorphic rhabdomyosarcoma of the chest wall.

To the Editor: A 65-year-old men was referred to our hospital with a complaint of giant mass on the chest wall, which reached its present size to 3 cm in 5 months. On physical examination, the mass was firm, fixed, necrotized, and nontender (Figure 1). Metastatic lesions were detected in the lung. An incisional biopsy of the tumor confirmed the diagnosis of pleomorphic rhabdomyosarcoma, 2 months ago in another clinic. The patient was considered as inoperable because the lung was metastatic, and the mass excision was not performed. Serous leakage, observed in the incision area, was irritating for the patient. The patient brought to our clinic for the mass excision. The mass was totally excised. The size of the tumor was 16 16 15 cm, and the weight was 1750 g. The chest wall and the axillary skin defect were reconstructed with a latissimus dorsi muscle flap. The skin was primarily closed. After the operation, the patient has received chemotherapy in an oncological center. The postoperative course was uneventful, and no recurrence was found. The patient is still alive after 6 months follow-up and was satisfied from the operation. Surgical excision has not seemed to contribute to the improvement in survival after the mainstay of local disease control on chest wall rhabdomyosarcoma.1 The excision of giant tumors is usually not preferred because of its hardness, and it is useless for survival. Still, resection of giant mass can improve the patient’s condition and may provide a good quality of life.2 Rüstü Köse, MD Department of Plastic and Reconstructive Surgery Harran University Medical School Sanliurfa, Turkey