Isolated Spleen Metastasis from Lung Adenocarcinoma: A Case Report

Solitary splenic metastasis is extremely rare with few reported cases in literature. Current study reports the case of a 74-year-old, female patient who was diagnosed isolated spleen metastasis after lung adenocarcinoma, in the postoperative course. She presented with the incidental detection of nodular liver and central splenic lesions in a follow-up abdominal computed tomography (CT) scan after 5 years from the left lower lobectomy due to lung adenocarcinoma. By MRI examination, lesion in the liver was characterized as cystic and the central splenic lesion was found having a heterogeneous hypoechoic nodular character. Tru-cutbiopsy of spleen confirmed metastasis of lung adenocarcinoma. The patient underwent splenectomy. Although liver biopsy couldn’t detect any malignant tissue, lung cancer adenocarcinoma metastasis was diagnosed in splenectomy material. Herein, we report a case of incidentally found solitary splenic metastasis, 5 years after left lobectomy for lung adenocarcinoma.

Increased exercise capacity after a flexibility session in a patient with partial pulmonary lobectomy

Introduction: Partial lobectomy is one of the surgeries chosen in the early stages of some diseases such as lung cancer. After thoracic surgeries or some respiratory diseases, both hard and soft structures undergo changes that lead to stiffness, lack of mobility, changing the mechanics and the correct respiratory pattern. Case presentation: A 75-year-old female patient entered the pulmonary rehabilitation program of the “Hospital de la Baxada” at Paraná, Entre Ríos, Argentina; referred to by a lower left lobectomy due to lung cancer. Treatment and evolution plan: The patient attended the pulmonary rehabilitation program, for 6 weeks she trained varying the load. We observed a significant change in recovery, compared at the minute of completing the first test the dyspnea was 4 and in the second test 3, the patient told us that after the flexibility session she felt she was able to breathe normally. Conclusion: In the case presented, the application of flexibility techniques increased exercise capacity.Keywords: cancer, flexibility, pulmonary rehabilitation.

Diagnosis of Primary Hydatid Cyst of Thyroid Gland: A Case Report

A 34-year-old female patient was presented to the general surgery clinic of the hospital complaining of a growing tangible swelling in her neck. In physical examination, the patient had two palpable soft nodules in the left lobe of the thyroid which hadn’t invaded the surrounding tissues. The function of thyroid gland was normal and fine needle aspiration (FNA) result reported it benign. The patient went through a left lobectomy and isthmectomy. The histopathology report concluded a nodular hyperplasia and a Hydatid cyst. After surgery, the patient was examined searching for any other organs cyst, but there were no cystic lesion in the cranial, thoracic and abdominal cavities. Accordingly, the case was a primary thyroid hydatid cyst, which is rare, even in endemic regions like Iran.

Cervical Paraganglioma Mimicking Thyroid Nodule: A Rare Clinical Case

Objective. Paraganglioma is a rare neuroendocrine tumor. When it is located in the neck, it is commonly misdiagnosed as other thyroid neoplasms.Case Report. We report a case of cervical paraganglioma in a 55-year-old female. Patient was admitted to our clinic with goiter and neck pain. Thyroid ultrasonography revealed a 20 mm solitary, heterogeneous nodule located in the upper pole of left thyroid lobe. Fine needle aspiration cytology was nondiagnostic. She underwent left lobectomy and histopathology showed paraganglioma.Discussion. Cervical paragangliomas should be considered in the differential diagnosis of thyroid nodules.

A primitive neuroendocrine liver tumour?

The aim of the present report is to present a possible primitive case of a neuroendocrine tumour (NET) of the liver. During a routine ultrasound examination, a 51-year-old woman was diagnosed with a lesion in the second segment of the liver, suggestive of a metastasis. A well differentiated neuroendocrine carcinoma (G2, Ki67 = 4.4%) was identified by liver biopsy, positive for chromogranin, synaptophysin and neuron specific enolase. An additional extensive examination aimed at finding the primitive lesion was unsuccessful and PET with 68Gallium revealed a single liver lesion. A left lobectomy was performed, but 15 months later a second liver lesion with the same characteristics as the previous one was observed and was surgically treated, followed by therapy with octreotide LAR 30 mg. A four-year follow-up did not show evidence of a different primitive NET: therefore, while it is improbable that a metastatic G2 primitive tumour would not have presented in the 4-year period, a diagnosis of primitive NET of the liver was made. The paper gives the opportunity of describing an unusual case of a primitive liver neuroendocrine tumour and of presenting the successful treatment of both surgery and cytoreductive pharmacological therapy.