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Gorham-Stout disease (GSD) is an extremely rare musculoskeletal disease of unknown aetiology characterised by non-neoplastic proliferation of vascular and lymphatic channels causing massive osteolysis, typically affecting younger individuals. Chylothorax is a known complication of GSD which is postulated to occur from thoracic spine involvement leading to pleural or thoracic duct invasion. In our case, bilateral chylothorax developed in a 60-year-old woman without any thoracic spine involvement of her disease, challenging the proposed mechanism. Despite bilateral pleural drainage and escalating doses of sirolimus, she ultimately developed respiratory failure and shock and succumbed to her illness. Overall survival of GSD is unknown, but when complicated by chylothorax, prognosis is typically poor. GSD represents a diagnostic and management challenge due to the paucity of knowledge surrounding its aetiology and management. These patients require multidisciplinary coordinated care. It is also important to note its high mortality when associated with chylothorax in particular.

Neuroendocrine tumors (NETs) are unusual neoplasms with a diverse spectrum of clinical presentations. There is a lack of literature on cases of 2 primary histologically distinct NETs. We report a case of a 40-year-old man who presented with chronic diarrhea. A colonoscopy was performed which discovered a rectal polyp, with pathology showing a well-differentiated NET. A subsequent somatostatin scan revealed a pancreatic tail mass. Biopsy showed a histologically distinct well-differentiated vasoactive intestinal peptide-producing NET. Given that pancreatic and rectal NETs come from different embryonic origins, the diagnosis of 2 primary NETs presents a unique case.

Goal theory explains the relationship between setting specific goals and the increased likelihood of achieving those goals, along with a mutually beneficial relationship with self-efficacy. When students enter an engineering program, they are often asked to declare a major; however, after this initial, long-term goal-setting experience, there is little room for students to engage in continual goal monitoring and refining. During a series of portfolio construction studios, it was determined that engineering students participated in the dynamic process of goal setting and monitoring as a result of portfolio construction. While portfolios are often used as an assessment tool in educational practice, there are several learning outcomes that have been associated with portfolio construction that are less studied, such as goal setting and monitoring, intellectual development, and self-authorship. This paper presents two case studies that highlight goal setting and monitoring as an outcome of portfolio construction by engineering students in the context of a studio environment.