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Renal cell carcinoma (RCC) most commonly metastasizes to the lung, adrenals, brain and pancreas, but metastasis to the stomach is uncommon. We present a 77-year-old male who underwent left nephrectomy 9 years previously for RCC with known metastatic disease to the lungs, diaphragm and stomach, and required multiple transfusions for acute blood loss anemia. A previous esophagogastroduodenoscopy revealed a large, friable, ulcerated mass at the gastric cardia. Biopsies of the mass demonstrated clear-cell carcinoma compatible with metastatic RCC. After multiple attempts at endoscopic, procedures and embolization were unsuccessful at controlling bleeding, the patient was treated with palliative total gastrectomy with Roux-en-Y gastric bypass. At discharge, the patient had been hemodynamically stable and tolerating a liquid diet. This case report highlights the presenting symptomology of RCC, explores the rarity of gastric metastases, and reviews current literature on management strategies for these patients.

Patient: Female, 3-week-old Final Diagnosis: Thyroglossal duct cyst Symptoms: Infection • neck mass • respiratory distress Medication: — Clinical Procedure: Incision and drainage • Sistrunk’s procedure Specialty: Otolaryngology • Pediatrics and Neonatology Objective: Congenital defects/diseases Background: Thyroglossal duct cysts are the most common congenital cervical anomalies, often presenting as midline neck cysts. The mean age of presentation of pediatric thyroglossal duct cysts varies between 5 and 9 years old, with rare cases younger than 1 year old. This case report details a rare case of an infected thyroglossal duct cyst presenting during the neonatal period as an upper airway obstruction. Case Report: A 3-week-old neonate born full-term with no complications during pregnancy or labor presented with a 5-day history of worsening nasal congestion and upper airway obstruction after an upper respiratory infection. Physical examination revealed a large midline neck mass measuring 3.1×4.2×3.2 cm abutting the hyoid with internal echogenicity consistent with a thyroglossal duct cyst, causing posterior tongue compression of the airway and airway distress. The patient was emergently taken to the operating room for incision and drainage, where she underwent a difficult intubation due to superior-posterior tongue displacement and global supraglottic edema. She was discharged on postoperative day 5 on a course of Augmentin after cultures grew methicillin-sensitive Staphylococcus aureus . The patient had no further complications, with successful excision using a Sistrunk procedure 6 months later. Conclusions: Pediatric thyroglossal duct cysts most often present as an asymptomatic midline neck mass, with rare sequel-ae of infection and upper airway obstruction. This case report highlights the pathophysiology and presenting symptomology of thyroglossal duct cysts, explores the rarity of infected thyroglossal duct cysts in neonates, and reviews the current literature on management strategies for these patients.