A rare case of chest wall tuberculosis: Tuberculous scapulothoracic bursitis
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SUBMITTER: Iga N
PROVIDER: S-EPMC8551644 | biostudies-literature |
REPOSITORIES: biostudies-literature
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Project description:Background:Tuberculosis is a public health problem in developing countries. Tuberculosis of the chest wall is rare and often presents as cold abscess (to differentiate from pyogenic abscess) or pseudotumoral mass whose diagnosis is difficult and often requires a surgical biopsy. Patients and methods:The medical series of 16 patients with cold chest wall abscess treated with surgery in association to anti-tubercular therapy were analysed retrospectively for the period of 7 years between January 2011 to December 2017 at Mohamed V Military Teaching Hospital - Rabat - Morocco. Results:The clinical examination provided a correct preoperative diagnosis of the abscess in all cases. Five patients had a past history of pulmonary tuberculosis and three patients had concomitant active infection. There were 6 cases on the left side, 9 cases on the right side and one case on the anterior chest wall. All patients underwent surgical drainage and debridement with specimens for bacteriology and histology. It was not necessary to resect ribs or sternum in all cases (sample costal or sternal curettage in one case each). Anti-tubercular treatment was routinely administered (6-9 months) with drug combinations of Isoniaside, Rifampicin, Pyrazinamide and Ethambutol. The evolution was favorable in all cases without complications or recurrences. Conclusion:Drainage of chest wall abscess and complete debridement provide adequate treatment. Post-operative anti-bacillary therapy should be combined with surgical procedures to minimize local complications and recurrence of infection.
| S-EPMC7029049 | biostudies-literature
Project description: Not available
| S-EPMC7947501 | biostudies-literature
Project description:Tuberculosis of the musculoskeletal system is uncommon and constitutes 1% to 5% of all forms of tuberculosis. In total, 30% of skeletal tuberculosis involves the joints, the knee being the third most commonly affected after the spine and the hip. Knee tuberculosis commonly presents as synovitis or arthritis, and infected Baker's cyst is a rather rare presentation. It is believed to result from the propagation of tuberculosis of the knee joint into the cyst, as approximately one half of the Baker's cyst communicates with the knee joint and it appears as swelling in the medial aspect of the popliteal fossa. For tuberculous popliteal bursitis at the lateral aspect of the popliteal fossa, it may be an extra-articular extension of tuberculosis of the knee joint via the popliteal hiatus. Chemotherapy remains the cornerstone of treatment; surgery is indicated in recalcitrant cases. In this Technical Note, the technical details of endoscopic resection of recalcitrant tuberculous bursitis at the lateral aspect of the popliteal fossa are described. This minimally invasive technique has the advantage of better cosmetic results and fewer wound complications and reduces the extent of surgical dissection as compared with open surgery.
| S-EPMC8355177 | biostudies-literature
Project description:IntroductionSynovial sarcoma is a malignant tumour of mesenchymal origin with an aggressive character and a rare cervicofacial location. Its management is multidisciplinary in order to improve prognosis and survival.Case reportWe report the case of two rare and synchronous localizations of monophasic synovial sarcoma of the maxilla and chest wall in a 58-year-old woman, whose management was based on exclusive chemotherapy.DiscussionThe cervicofacial location of synovial sarcoma represents 3% of all locations in the body. Its clinical and radiological manifestations are aspecific. Its diagnosis is based on a combination of histological and genetic arguments. Its therapeutic management depends on the tumour stage and prognostic factors.ConclusionEarly diagnosis of cervicofacial synovial sarcoma allows to avoid a mutilating procedure for the patient and to improve the long-term prognosis by a good control of the tumour.
| S-EPMC8234347 | biostudies-literature
Project description: Not available
| S-EPMC7212140 | biostudies-literature
Project description:Tuberculosis is a chronic granulomatous systemic infectious disease caused by Mycobacterium tuberculosis. The oral lesions found in tuberculosis are relatively rare and may present as ulcers, erythematous patches, indurated lesions, nodules or as bony jaw lesions. Oral tubercular lesions sometimes present a confusing clinical presentation and can be overlooked. Hence, we document a case of tuberculous osteomyelitis of the maxilla in a 19-year-old female patient, who was initially treated for multiple periodontal dental abscesses, which later proved to be tubercular osteomyelitis of the maxilla. Although it is a rare occurrence, the differential diagnosis of tuberculous osteomyelitis must always be considered when it fails to respond to routine therapy.
| S-EPMC4405963 | biostudies-literature
Project description:Desmoid-type fibromatosis (DF), also known as deep fibromatosis or desmoid tumor, is an extremely rare neoplasm that develops from fascia and musculoaponeurotic tissue. These tumors are characterized by slow progressive growth, local invasion, and local recurrence after surgical excision, but they lack metastatic potential. DF accounts for 3.5% of all fibrous tumors, with an annual incidence of approximately 2-4/million. Until now, only a small number of cases have been found in the chest wall. Herein, we present a rare case of chest wall DF in a 43-year-old female, which was discovered accidentally due to a thoracic wall mass that extended outward from the sternum. Computed tomography scans revealed a subcutaneous soft tissue mass anterior to the sternum, which was considered to be a mesenchymal tumor or an inflammatory lesion. The patient underwent surgical excision of the mass. The mass was completely removed and all margins were negative. According to the pathological results, the patient was finally diagnosed as DF. Postoperative radiotherapy was suggested subsequently, especially considering the locally aggressive and infiltrative nature of the tumor. However, this was rejected by the patient, and biannual re-examination was recommended instead. Despite the absence of postoperative radiotherapy, there was no evidence of local recurrence 2 years later. We consider regular postoperative follow-up may be able to replace postoperative radiotherapy, and if there exist an opportunity to completely resect the mass, surgical is a worthwhile choice.
| S-EPMC7661858 | biostudies-literature
Project description:Chest wall tumors are a relatively uncommon disease in clinical practice. Most of the published studies about chest wall tumors are usually single-center retrospective studies, involving few patients. Therefore, evidences regarding clinical conclusions about chest wall tumors are lacking, and some controversial issues have still to be agreed upon. In January 2019, 73 experts in thoracic surgery, plastic surgery, science, and engineering jointly released the Chinese Expert Consensus on Chest Wall Tumor Resection and Chest Wall Reconstruction (2018 edition). After that, numerous experts put forward new perspectives on some academic issues in this version of the consensus, pointing out the necessity to further discuss the points of contention. Thus, we conducted a survey through the administration of a questionnaire among 85 experts in the world. Consensus has been reached on some major points as follows. (I) Wide excision should be performed for desmoid tumor (DT) of chest wall. After excluding the distant metastasis by multi-disciplinary team, solitary sternal plasmacytoma can be treated with extensive resection and adjuvant radiotherapy. (II) Wide excision with above 2 cm margin distance should be attempted to obtain R0 resection margin for chest wall tumor unless the tumor involves vital organs or structures, including the great vessels, heart, trachea, joints, and spine. (III) For patients with chest wall tumors undergoing unplanned excision (UE) for the first time, it is necessary to carry out wide excision as soon as possible within 1-3 months following the previous surgery. (IV) Current Tumor Node Metastasis staging criteria (American Joint Committee on Cancer) of bone tumor and soft tissue sarcoma are not suitable for chest wall sarcomas. (V) It is necessary to use rigid implants for chest wall reconstruction once the maximum diameter of the chest wall defect exceeds 5 cm in adults and adolescents. (VI) For non-small cell lung cancer (NSCLC) invading the chest wall, wide excision with neoadjuvant and/or adjuvant therapy are recommended for patients with stage T3-4N0-1M0. As clear guidelines are lacking, these consensus statements on controversial issues on chest wall tumors and resection could possibly serve as further guidance in clinical practice during the upcoming years.
| S-EPMC8674598 | biostudies-literature
Project description:BackgroundEpipericardial fat necrosis (EFN) is a rare cause of chest pain, which is often unrecognized.Case summaryA 58-year-old man previously known with a transient ischaemic attack presented with a sharp, substernal chest pain. Pulmonary embolism was ruled out by computed tomography (CT) angiography. However, CT angiography revealed an inhomogeneous epipericardial mass. On cardiovascular magnetic resonance imaging, the mass had an inhomogeneous signal intensity without infiltration of surrounding tissue. Late gadolinium enhancement imaging showed subtle hyperenhancement. Tissue characterization by means of parametric mapping revealed very low native T1 relaxation times and increased T2 relaxation times. In conclusion, the epipericardial mass showed fibrofatty inflammatory markers, suggestive of EFN. The chest pain resolved spontaneously. Follow-up CT 3 months later showed a marked regression of the mass which confirmed the diagnosis EFN.DiscussionEpipericardial fat necrosis is a benign and self-limiting inflammatory cause of chest pain, which can be diagnosed with multi-modality imaging and must not be overlooked in the differential diagnosis of patients with acute pleuritic chest pain.
| S-EPMC8796805 | biostudies-literature
Project description:Computer modeling and 3D printing has found wide-scale applicability in pre- and intraoperative meticulous planning of surgery. Dr. Harsh Singh from Christchurch Hospital, New Zealand, discusses its current and future role in chest wall reconstruction.
| S-EPMC7525701 | biostudies-literature