No abstract

Here, we present a rare case of spontaneous hemorrhagic rupture of a benign thyroid cyst in an adult Indian female who had no history of thyroid gland disease, trauma or coagulopathies. The patient presented to the Emergency Department with a suddenly progressive left-sided neck swelling of short duration. A 36-year-old otherwise healthy female presented to our Emergency Department with a progressive swelling on the left side of her neck that had started 2 days before her visit. Initially, the clinical neck examination revealed a well-defined soft cystic lesion confined to the left side of the neck anteriorly, measuring around 4 cm × 4 cm, tender to touch and moving with deglutition. Preliminary flexible scope examination of her larynx was normal. Within a few hours of having undergone ultrasonography examination, the neck swelling became diffused with increased tenderness. However, the patient remained clinically stable with no signs of airway compromise. A repeat of the fiber optic flexible scope examination showed submucosal hematoma in the left aryepiglottic area that mildly pushed the patient's laryngeal inlet to the contralateral side. Shortly after, the patient's condition worsened with the progression of swelling leading to compression of the airway. This promoted the decision to intubate the patient, who was subsequently, managed conservatively with close monitoring in the intensive care unit. Postintubation ultrasonography and computer tomography scans showed diffused inflammatory changes on the left side of the neck in the superficial and deep planes, mainly confined to the infrathyroid. Spontaneous sudden hemorrhagic rupture of a thyroid gland cyst is a rare condition but should be considered in a massive abrupt neck swelling that could potentially be life threatening.

Although blunt neck trauma is known to be rare, occurring in approximately 5% of all neck traumas, undiagnosed cases may have a devastating outcome. Physicians need to fully understand the mechanism of the injury and the external laryngeal trauma signs. A physician's precise diagnosis and proper management are necessary to avoid long-term complications or death. Although blunt laryngeal injuries are uncommon, prompt recognition of the subtle signs is crucial to avoid the catastrophic complications associated with such injuries. This case report aims to demonstrate the symptoms and signs of laryngeal injury in a young healthy male following a road traffic accident.

Germ cell tumors (GCTs) arise along the midline, in which 50-70% of extragonadal GCTs occur in the mediastinum. Malignant GCTs are more common in males, while benign GCTs occur equally in both males and females. This report presents a case of a giant primary mediastinal nonseminomatous GCT resected from a 35-year-old male who presented with dyspnoea and tightness in the chest. Thorough investigations including a chest MRI were done. It showed a 21×19×15 cm tumor. Thus, surgical resection of the tumor through a midline sternotomy was done. Histopathological analysis diagnosed the tumor as a primary mediastinal teratocarcinoma with a sarcomatous component. Eighteen-month follow-up showed no tumor recurrence. Mediastinal teratocarcinoma is a rare and life-threatening germ cell tumor. Studies recommend the use of chemotherapy prior to resection as an important step in its management. Close and regular follow-up postsurgical resection is advised.

No abstract