Introduction: Acute suppurative thyroiditis is a rare and potentially life-threatening disease. The aim of the current study is to report a rare case of acute suppurative thyroiditis progressing to a thyroid abscess. Case report: A 67-year-old female presented with a painful neck swelling for one week. On Ultrasound examination, right thyroid lobe was enlarged due to a complex thick-walled mass with echogenic shadow. It pushed the right common carotid artery laterally. Computed tomography showed a well-defined collection in the right thyroid lobe with an enhancing margin. The center of the lesion was necrotic and contained gas, diffuse edema around the right thyroid lobe was also evident. The patient underwent right thyroid lobectomy and the result of histopathology examination was thyroid abscess without malignancy. Discussion: The clinical spectrum of acute suppurative thyroiditis is broad, since asymptomatic cases have been documented. Fever and painful anterior neck mass are the two of the most common clinical manifestations. Other frequent manifestations include dysphagia, hoarseness of voice, and sore throat. The pain may radiate to the chest, mandible, or ears. Conclusion: Acute suppurative thyroiditis progressing to an abscess formation is a rare but potentially life-threatening condition if left untreated. Highlights

Early diagnosis and appropriate staging workup are crucial for cancer patients. Whole-body magnetic resonance imaging (WB-MRI) has been proposed as another practical whole-body approach for assessing local invasiveness and distant metastases in patients newly diagnosed with cancer. The current study aimed to evaluate the efficacy of WB-MRI in assessing metastasis in patients newly diagnosed with cancer using histopathologic data as the reference method. A prospective observational study was performed from April 2018 to July 2020. MRI sequences were utilized to acquire anatomical and functional images in three orthogonal planes. The discovery was classified as nodal, skeletal and visceral metastases. Patient-based analysis was used for visceral metastasis and region-based for skeletal, systemic and lymph node metastases. A total of 43 consecutive patients (mean age, 56±15.2 years) were assessed successively. In 41 patients, there was a concordance between the WB-MRI and histological confirmation. The most prevalent site of metastasis was the skeletal system (18 patients). There were 12 individuals with liver metastasis, 10 with lung metastasis and 4 with peritoneal metastasis, with just one brain metastatic lesion found. On WB-MRI, 38 lymph node groups were deemed positive. Out of the total, 66 skeletal locations contained metastases. The accuracy of WB-MRI for nodal, skeletal and visceral metastases was (98.45, 100 and 100%, respectively). In conclusion, WB-MRI in three orthogonal planes, including the diffusion-weighted MRI with background body signal suppression sequence, may be utilized efficiently and accurately for assessing metastasis staging and may thus be utilized in patients with newly diagnosed cancer.

Bronchogenic carcinoma comprises >90% of primary lung tumors. The present study aimed to estimate the profile of patients with bronchogenic carcinoma and assess the cancer resectability in newly diagnosed patients. This is a single-center retrospective review conducted over a period of 5 years. A total of 800 patients with bronchogenic carcinoma were included. The diagnoses were mostly proven with either cytological examination or histopathological diagnosis. Sputum analysis, cytological examination of pleural effusion and bronchoscopic examination were performed. Lymph node biopsy, minimally invasive procedures (mediastinoscopy and video-assisted thoracoscopic surgery), tru-cut biopsy or fine-needle aspiration was used to obtain the samples for diagnosis. The masses were removed by lobectomy and pneumonectomy. The age range was between 22 and 87 years, with a mean age of 62.95 years. Males represented the predominant sex. Most of the patients were smokers or ex-smokers. The most common symptom was a cough, followed by dyspnea. Chest radiography revealed abnormal findings in 699 patients. A bronchoscopic evaluation was performed for the majority of patients (n=633). Endobronchial masses and other suggestive malignancy findings were present in 473 patients (83.1%) of the 569 who underwent fiberoptic bronchoscopy. Cytological and/or histopathological samples of 581 patients (91.8%) were positive. Small cell lung cancer (SCLC) occurred in 38 patients (4.75%) and non-SCLC was detected in 762 patients (95.25%). Lobectomy was the main surgical procedure, followed by pneumonectomy. A total of 5 patients developed postoperative complications without any mortality. In conclusion, bronchogenic carcinoma is rapidly increasing without a predilection for sex in the Iraqi population. Advanced preoperative staging and investigation tools are required to determine the rate of resectability.

Introduction and importance Single-port video-assisted thoracoscopic surgery is a less invasive approach for patients undergoing a bullectomy. This report demonstrates a case of post-single-port video-assisted thoracoscopic surgery of rhomboid muscle herniation into the thoracic cavity. Case presentation A 35-year-old lady presented with a 1-month history of dyspnea due to single large lung bullae of 13 cm × 10 cm. She underwent bullectomy using single-port video-assisted thoracoscopic surgery and recovered well thereafter. Four months later, the patient presented with pain at the site of the incision with a severe cough. During the workup, radiographic images showed herniation of the rhomboid major muscle into the thoracic cavity. Clinical discussion Intercostal herniation of thoracic soft tissues can be in the form of lung herniation or inverted intercostal herniation of other soft tissues. It is an extremely rare disorder and mainly occurs after an anterior thoracotomy. Conclusion Muscle herniation is a rare complication following video-assisted thoracoscopic surgery. Proper closure of the wound including periosteal stitches might be necessary to prevent this complication. Highlights

Introduction and importance Leiomyomas can affect 20–30% of women of reproductive age and are commonly observed in the uterus. Their occurrence in the vagina is exceedingly rare, representing the least common presentation among all locations. Herein, we report a case of vaginal leiomyomas in a 48-year-old lady. Case presentation A 48-year-old female presented to our gynecology clinic complaining of feeling a mass within her vagina. Physical examination revealed a round, smooth mass in the anterior vaginal wall with a normal-looking cervix. Ultrasound examination showed an enlarged anteverted uterus with an endometrial thickness of 14 mm and an endometrial polyp of 15 × 7mm arising from the left upper anterolateral wall. Magnetic resonance imaging demonstrated a well-defined, fusiform, submucosal vaginal mass originating from the anterior vaginal wall, measuring 37× 22 × 36 mm. Hysteroscopy was performed, and the uterine and vaginal masses were resected. The masses were confirmed to be conventional leiomyomas. Clinical discussion The diagnosis is seldom established preoperatively and the preferred therapeutic approach for treating vaginal leiomyoma is surgical removal via the vaginal route. However, in the case of large tumors, the abdominoperineal route may be necessary. Conclusion Vaginal leiomyoma is a rare tumor with approximately 300 reported cases worldwide. It can be asymptomatic or cause to feel it within the vagina. Besides the necessity of surgical resection, colporrhaphy as a reconstructive surgery may be required.