In this study, we report an extremely rare case of liposarcoma which arises primarily in mediastinum. The patient appeared to have progressive dyspnoea and prolonged cough for a duration of one year. Chest radiograph and Computed Tomography (CT) of the thorax revealed a large right mediastinal mass with fatty component. It was confirmed to be primary liposarcoma on histopathological examination.
This paper highlights a potentially life threatening and unsuspected case of multiple small pseudoaneurysms from the thyrocervical and costocervical branch of the left subclavian artery that was spontaneously ruptured. The cause was not suspected prior to thoracic CT angiography (CTA) because the initial pre-emptive diagnosis was only trivial spontaneous hydropneumothorax which became serious after a chest tube was inserted.
Internal obstruction of the upper airways can be due to infection, anaphylactic reaction, congenital anomaly, foreign body inhalation or mass. This case report is of a lady who presented with upper airway obstruction due to subglottic ectopic thyroid tissue. She had a history of noisy breathing and progressive neck swelling since childhood. Biochemical results showed hypothyroid features while flexible scope showed tracheal stenosis. Computed Tomography (CT) detected a goitre and a posterior laryngeal mass at subglottic region causing laryngeal stenosis. The MRI helped to better delineate the soft tissue details of this mass. while elective direct laryngoscope showed a firm mass arising from the trachea. Debulking of the mass was done and histopathological diagnosis was nodular thyroid hyperplasia. Treatment with L-thyroxine was instituted with good clinical improvement. An ectopic thyroid gland can develop if its normal migration is halted along this tract during embryogenesis. Subglottic location of ectopic thyroid is extremely rare. However, ectopic thyroid tissue in the larynx should be considered as a possible diagnosis causing upper airway obstruction, especially in a patient that is clinically hypothyroid and having a concurrent goitre.
Popliteal artery injury is the most disastrous intraoperative complication during total knee replacement. This study aims to determine the mean distance between the popliteal artery (PA) and the tibial plateau in normal and osteoarthritic patients who underwent Dual Energy CT Angiography (CTA) of the lower limb.
Materials and Methods: All CTA lower limb examinations from January 2013 to October 2014 were retrospectively reviewed. The distance between the PA the tibial plateau distance and the thickness of popliteus muscle were electronically measured. We used modified Kellgren and Lawrence’s Classification to grade the osteoarthritis in patients who underwent CT examinations regardless of symptoms.
Results: There were a total of 126 patients who underwent CTA (93 males and 33 females). 54 of them were Malays, 47 Indians, and 24 Chinese. The mean age of patients was 58 years (range 16 to 92). The mean PA-totibial plateau distance was 9.9 mm for the right lower limb (range 2.5 mm to 17.2 mm) and 10.24 mm for the left (range 5.5 mm to 15.4 mm). There were no significant correlations between PA-to-tibial plateau distance with osteoarthritis grade, age, gender, and racial origin (P > 0.05); however, there was a positive
correlation between PA-to-tibial plateau distances with popliteus muscle thickness (P = 0.000).
Conclusion: Osteoarthritic condition in the knee does not reduce the popliteal artery to the tibial plateau distance. Hence, a higher osteoarthritic grade does not impose additional risks with regards to popliteal artery to tibial plateau distance, with relatively similar arterial injury risks compared to normal knees.