Introduction Liposarcoma is the most common soft tissue tumor which is commonly found in the retroperitoneal region. This kind of tumor is usually well-differentiated with low to no potential to metastasize. Thymoliposarcomas are extremely rare tumors that are difficult to diagnose and differentiate from thymomas and other benign conditions . Presentation of a case:This report presents a case of a 46-year-old male patient with dyspnea, generalized fatigue and non-specific chest pain caused by a giant anterior mediastinal mass. Computed tomography scan revealed a large mass in the anterior mediastinum. CT guided biopsy was consistent with thymolipoma. The tumor was surgically resected. The histological analysis of the tumor revealed thymoliposarcoma. Discussion:Thymoliposarcoma usually presents with non-specific symptoms. The mean age of the diagnosis is 55.8 years old with a slight predominance in males. The corner stone of the treatment remains surgical excision of the tumor while the role of adjuvant therapy is not well documented.

Myasthenia Gravis (MG) is a chronic autoimmune neuromuscular disease. Although it is well known that patients with myasthenia gravis have a higher incidence of other autoimmune disorders, however, its association with pituitary adenomas is extremely rare. We believe that our case represents the 8th of this association and the 2nd case involving a GH-secreting adenoma. Here we report a case of a 45-year old Syrian woman who presented with typical complaints of myasthenia gravis as she was suffering from variable painless and effort-related dysphagia and dysarthria. Her complaints became more evident at the end of the day, while acromegaly only manifested as a 4-month history of headache and a special facies that was noted by the physician. Brain MRI scan demonstrated a 3.21 x 2.42 x 2.35 cm pituitary mass for which the patient underwent a trans-sphenoidal pituitary tumor resection. In addition, postoperative histopathological investigations confirmed the diagnosis of a GH-secreting macroadenoma. On following up, it was observed that her myasthenic symptoms improved significantly on Pyridostigmin and Prednisolone. In conclusion, the presence of headache in a myasthenic patient should raise the attention for other underlying causes including pituitary tumors.

Alveolar hemorrhage following thrombolytic agents administration is an extremely rare entity that has only been reported in twenty two patients in the medical literature. We herein report a case of a 60-year old male with an acute ST-elevation myocardial infarction who was treated with Streptokinase. Twelve hours after streptokinase adminstration, the patient developed severe hemoptysis and dyspnea and radiological studies were highly suggestive for acute alveolar hemorrhage. His past medical history is significant for severe chest trauma ten months prior to presentation. . Conservative therapy in addition to anti-coagulants withdrawal has led to gradual improvement in the next six days. We also discussed the aspects of our patient in comparison with published cases.

Background Caustic substance ingestion is a high-risk medical emergency associated with high mortality and morbidity. To date, there are several treatment options with no standard method of care. Case presentation We report a case of a corrosive agent ingestion complicated with third-degree burns and severe stenosis of the esophagus and gastric outlet. After failure of conservative treatment, the patient underwent jejunostomy placement for nutritional support followed by transhiatal esophagectomy with gastric pull-up and intra-thoracic Roux-en-Y gastroenterostomy with good outcomes. The patient recovered from the procedure and has been tolerating oral intake very well with significant weight gain. Conclusion We put a new technique for treating severe gastrointestinal injuries caused by corrosive agent ingestion that resulted in both esophageal and gastric outlet strictures. These rare complex cases requires difficult treatment decisions. We believe that this technique provides many benefits for such cases and might be a feasible alternative for colon interposition.

Leiomyosarcoma (LMS) of the gallbladder is an extremely rare entity. Most reported cases were mistakenly diagnosed preoperatively as cholecystitis with or without cholelithiasis. We believe that our article demonstrates the 5th case of gallbladder LMS that was suspected preoperatively to be malignant rather than cholecystitis, which fortunately led to radical resection of the tumor instead of simple cholecystectomy. However, the definitive diagnosis relies exclusively on histological and immunohistochemical techniques. We present a case of a 62-year-old Caucasian female complaining of signs and symptoms suggestive for cholecystitis. On ultrasonography, the gallbladder appeared enlarged and filled with a necrotic mass; thus, the presence of adenocarcinoma was suspected. Multislice Computerized Tomography (MSCT) demonstrated no distant metastasis. An extensive radical cholecystectomy was performed, and histological techniques confirmed a leiomyosarcoma diagnosis. In addition, adjuvant chemotherapy of doxorubicin and ifosfamide was administrated. The patient was on follow-up for 2 years and is doing well till date. The discrimination of gallbladder sarcoma preoperatively remains a clinical and radiological challenge. Although radical resection of the tumor remains the mainstay of the treatment, we believe that adjuvant chemotherapy should be administrated in such cases. However, further studies are required in this field.