1/6. Unusual late extrapulmonary metastasis in osteosarcoma.The major site of metastasis from osteosarcoma is the lung, and over 90% of fatalities in patients with this disease die from pulmonary metastases. Extrapulmonary disease is developing in an increasing proportion of patients, usually after pulmonary metastasis. This study reports three cases of patients with osteosarcoma that metastasized to the brain, mediastinum, intramuscular site, and pelvic cavity. The physician must be aware that extrapulmonary metastases may be present at the time a pulmonary metastasis becomes evident.- - - - - - - - - - ranking = 1keywords = physician (Clic here for more details about this article) |
2/6. A thoracoscopically resected case of mediastinal parathyroid cyst.A 67-year-old male visited his physician because of a 2-month history of cough and sputum. An abnormal shadow at the left upper mediastinum on chest x-ray film was detected, and the patient was referred to our department for further examination. Chest x-ray film revealed a round shadow at the left upper posterior mediastinum. Computed tomography(CT)revealed a uniform iso density mass about 4 cm in diameter, with a well-defined border. After the intravenous contrast administration, a slight peripheral enhancement was seen around the mass. On magnetic resonance imaging, the mass was hypointense in T1-weighting and hyperintense in T2-weighting. The contrast pattern was the same as that observed in the CT scan. On sagittal and coronal sections, the mass was adjacent to the aortic arch. Although a benign tumor was mostly suspected based on imaging findings, a malignant tumor was also possible. Accordingly, we resected this mass with video-assisted thoracoscopy. Findings at operation were a cystic mass. The pathological findings were compatible with benign parathyroid cyst, which was suspected to be the cystic degeneration of a parathyroid adenoma.- - - - - - - - - - ranking = 1keywords = physician (Clic here for more details about this article) |
3/6. Inappropriate antidiuretic hormone complicating histiocytic lymphoma.The syndrome of inappropriate antidiuretic hormone (IADH) often causes the hyponatremia that may be seen in patients with malignant disorders. Most physicians correctly associate IADH with small cell carcinoma of the lung. We describe two patients in whom IADH was caused by histiocytic lymphoma. One patient was thought to have small cell carcinoma of the lung on the basis of marrow infiltration and the IADH. When the proper diagnosis was made and therapy instituted, both patients responded, with rapid resolution of their disease and the IADH. The identification of the neoplasm that produces the IADH is important, since histiocytic lymphoma may mimic small cell carcinoma of the lung, yet may be very responsive with newer treatment regimens.- - - - - - - - - - ranking = 1keywords = physician (Clic here for more details about this article) |
4/6. Tracheal obstruction presenting as new-onset wheezing.Two cases of recent-onset dyspnea and wheezing initially treated with bronchodilator therapy for presumed reactive airway disease are presented. Plain-film chest radiographs subsequently demonstrated mediastinal masses causing extrinsic tracheal compression. The first patient had inoperable poorly differentiated squamous cell carcinoma resistant to radiotherapy. The second patient underwent resection of a substernal multinodular goiter with complete resolution of symptoms. The physician should always entertain the diagnosis of upper airway obstruction in all adult patients with new-onset wheezing. New-onset adult wheezing of uncertain etiology should prompt the physician to refer the patient for pulmonary function testing with flow-volume loops.- - - - - - - - - - ranking = 2keywords = physician (Clic here for more details about this article) |
5/6. superior vena cava syndrome associated with gynecologic malignancy.superior vena cava syndrome is an infrequently noted complication associated with gynecologic malignancy. Three cases illustrate modern diagnostic and management methods. patients developed superior vena cava syndrome secondary to mediastinal metastatic endometrial carcinoma, uterine leiomyosarcoma, and secondary to thrombosis induced by a subclavian hyperalimentation catheter. awareness of this condition on oncology units and by physicians using central venous catheters is important to afford the prompt diagnosis and appropriate management of this life-threatening condition.- - - - - - - - - - ranking = 1keywords = physician (Clic here for more details about this article) |
6/6. Anterior mediastinal mass in a young man.The case is presented of a patient in whom the diagnosis of Klinefelter's syndrome was made only after a mediastinal teratoma was discovered. Chest physicians should be aware of this association since they are often the first to evaluate patients with mediastinal masses.- - - - - - - - - - ranking = 1keywords = physician (Clic here for more details about this article) |