HighlightsEctopic Cushing’s syndrome is a form of Cushing’s in which a tumor outside the pituitary gland produces a hormone called (ACTH).Small cell carcinoma and carcinoid of the lung comprises half of its cases.Ectopic cushing syndrome is a complicated medical problem especially when it comes to identification of the ectopic spot.The surgical treatment could be curative when the spot is determined.

Leiomyomas are the most common pelvic tumors in women. About 20–30% of women older than 35 are affected. Rare conditions of leiomyomas have extrauterine locations. Myxoid degeneration is a rare type of leiomyoma degeneration. We report a case of solid-cystic myxoid leiomyoma in a 53-year-old woman complained of constipation, urinary hesitation, and malodorous vaginal discharge with palpable 17 × 12 cm mass between vagina and rectum. Regarding the inferior location of the mass, a perineal approach was used to enucleate it. This rare location has not been mentioned before. The woman was finally diagnosed by pathologists which was myxoid leiomyoma.

Background and aim The efficacy of the superior trans‐septal (STS) approach to the mitral valve has been offset by the perceived risks of adverse postoperative events. The aim of this study was to review our experience with using the left atriotomy (LA) and STS approaches in patients undergoing mitral valve surgery. Methods Charts of patients who underwent mitral valve surgery by a single surgeon over a period of 20 years were reviewed retrospectively. A total of 319 patients (aged 42.9 ± 16.2 years) were studied. Surgical operations were carried out through the LA approach in 111 patients, and through the STS approach in 208 patients. Results The two groups were comparable in terms of patients’ characteristics, but cardiopulmonary bypass and aortic cross‐clamp times were longer in the STS approach group (P = .0005). No technical complications related to either approach occurred. Rates of re‐exploration for postoperative bleeding, durations of intensive care unit (ICU) stay, in‐hospital days, and mortality were comparable in both approaches. Statistical analyses indicated that a patient was more likely to maintain a preoperative sinus rhythm if the LA approach rather than the STS approach was used (P < .05). On the other hand, when the preoperative heart rhythm was atrial fibrillation, no significant difference in perioperative changes in heart rhythm was observed between the two approaches. Conclusions This study confirms that the routine use of the STS approach is not associated with important adverse postoperative outcomes, but is associated with increased incidence of postoperative sinus node dysfunction in patients who were in sinus rhythm preoperatively.

HighlightsMusculoskeletal involvement with hydatid cystic disease accounts for less than 5% of all cases.This low incidence is related to the filtering function of the liver and lungs.Surgery is the optimal treatment of hydatid disease.

This report highlights the need for close surveillance of bioprosthetic valves. Unaccountable degeneration of bioprosthetic valves can develop early after implantation and usually requires replacing the failed valve with a mechanical prosthesis.