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Extraskeletal chondromas are rare benign neoplasms comprising mature hyaline cartilage. A distinctive feature of these tumors is that they develop in soft tissues away from bone and cartilage. Extraskeletal chondromas account for 1.5% of benign soft tissue tumors. They occur predominantly at 30-60, in males, and in the hand or foot. In only 4% of cases, the tumor is located not on the extremities. Patients predominantly complain of increased mass, rarely on pain or a pulling sensation. The literature on the chondromas of the anterior abdominal wall is scarce. We present a rare case of a large extraskeletal left inguinal chondroma in a 71-year-old patient. The mass was over 6 cm large, and this is the only case of inguinal chondroma described in the literature. The mass was resected with surrounding tissues (a surgical margin of 1 cm) under combined endotracheal anesthesia and the histology confirmed the tumor to be a chondroma.

Introduction: Technetium-99m (99mTc) is a short-lived nanocolloid nuclide widely used by oncologists to diagnose and identify cancer dissemination. Aim: The aim of the current study was to develop the technique of radiopharmaceutical preparation (RPP) of Technefit99mTc aimed at examining sentinel lymph nodes (SLN) before surgery. Materials and methods: We performed a series of trials (33 patients). Based on the information obtained from the portable gamma detector NEO2000 during surgery, a biopsy of the sentinel lymph nodes was carried out when RPP Technefit 99mTc accumulated in a specific lymph node. Results: We determined maximum activities, volume, and peculiarities of administration of radioactive colloid Technefit99mTc in order to examine and perform the biopsy of SLN in the patients with malignant tumors. The most informative results in terms of scintigraphy images of sentinel lymph nodes were revealed in the first trial of the research, with all 5 cases (100%) showing positive results. The first trial included Technefit intradermal-hypodermal injection into one point above the tumor node, RPP activity of 75 to 200 mBq at a room temperature of 21°C, without preliminary anesthesia with Novocain solution. Conclusion: We determined the most efficient dosages of activities, volume, and characteristics of radioactive colloid administration aimed at the examination and biopsy of sentinel lymph nodes using the radiopharmaceutical preparation Technefit 99mTc in patients with malignant tumors of different localizations, namely breast cancer and skin melanoma. In some cases, we did not find any signs of considerable lowering of the Technefit 99mTc activity, which shows that there is a very slow filtration of Technefit 99mTc through the pores of lymph capillaries.

Polyacrylamide hydrogel mammoplasty is a simple and relatively affordable surgery. However, this procedure is associated with a significant frequency of late complications, prompting its suspension in 2006. Despite this, patients continue facing long-term consequences. These include hydrogel migration, changes in breast shape and volume, granulomas, fistulas, and abscess formation. The clinical case described here presents the surgical treatment after augmentation mammoplasty with polyacrylamide hydrogel performed 35 years ago.

Poland’s syndrome is an uncommon congenital anomaly of unknown etiology, the main characteristic of which is the absence of the major pectoral muscle. Thorax and upper limb malformations also may be present. Poland’s syndrome has been observed in clinical cases connected to a variety of neoplasia, primarily hematological disorders. Patients with Poland’s syndrome who have developed breast cancer have been reported incidentally. Here we report a case of Poland’s syndrome associated with breast cancer.

Extra-gastrointestinal stromal tumors arising from the pancreas are extremely rare. To date, just over 30 cases have been described in the world literature. A clinical observation of a 67-year-old patient with dull epigastric pain and a large cystic solid neoplasm instrumentally identified as an extra-gastrointestinal stromal tumor of the head of the pancreas is presented. The volume of surgical intervention consisted of pancreatogastroduodenectomy and right-sided hemicolectomy, since tumor invasion into the transverse mesocolon was detected intraoperatively. The final diagnosis of extra-gastrointestinal stromal sarcoma of the head of the pancreas with invasion into the mesocolon pT4N0M0, stage IIIb was made on the basis of histopathology and immunohistochemistry results. Extra-gastrointestinal stromal pancreatic tumors require careful differential diagnosis with other large abdominal masses. Timely diagnosis and use of modern treatment algorithms make it possible to avoid further disease progression.

Aim: The aims of this study were to evaluate the demographics and crash profiles of road traffic-related traumatic brain injury (TBI) patients treated at two emergency departments in the Republic of Moldova, and to identify areas for prevention. Materials and methods: A prospective study was conducted using data from the medical records of a pilot TBI registry from the emergency departments of two large hospitals in Moldova. The study sample included patients with TBI related to road traffic mechanisms from March 1 to August 31, 2019. Results: During the study period, 368 patients were included in the TBI registry, with 113 (30.7%) of them having TBIs caused by traffic. Children under the age of 18 (44.2%), people aged 30-49 (18.6%), and males (71.7%) were the largest proportions of the road traffic-related TBI patient population. Most (78.8%) of the TBI injuries occurred in a transportation area (street, road, highway, etc.), among children under age of 18, while walking (36.7%) or riding in a passenger vehicle (68.4%). Pedestrians (42.5%) accounted for the most cases, followed by passengers (33.6%) and drivers (23.9%). Over two-thirds of all cases were tested for alcohol. Most cases were in June (20.4%) and between 2 pm and 6 pm (29.2%) within the research period. Conclusions: This is the first study to examine the road traffic-related traumatic brain injuries in the Republic of Moldova, which underlines the high burden of injuries among males, children, and the middle-aged population. Results from this study will help to support the development of a country’s national TBI registry and can argue for the running of comprehensive measures in road injury prevention targeted to the most affected populations

Anomalies and variants of development of the pancreas are relatively frequent. Bifid pancreatic tail is a rare anatomic variation with only a few cases reported in the literature. The present case series were encountered during dissection of 50 anatomical specimens of the pancreas, spleen, and duodenum. We observed four unusual cases (8%) of bifid pancreatic tail. One case was of a vertically oriented bifid pancreas tail (2%), in another case, the tails here horizontally oriented (2%) and in two cases the bifid tails were horizontally oriented but unequal (4%). The bifid tails had an arterial supply that penetrated the glands between the tails and two out of four were also supplied by the superior horizontal pancreatic artery of Popova. The ductal system usually bifurcated at the level of the tails, but a case of trifurcation was also encountered. The current cases should be taken into account in hepato-pancreato-biliary surgery to avoid misdiagnosis and to comprehensively assess the patient preoperatively.

Adrenal gland incidentaloma (incidental – sudden, accidental) is a mass of the adrenal gland(s), accidentally detected by an instru-mental examination conducted for other reasons. The frequency of detection of this pathology based on computer tomography of the abdominal organs is 0.5%–2%. In most cases, the mass is represented by adrenocortical adenomas without hormonal secretion. It is an extremely rare case (less than 1% of all cases) when the adrenal incidentaloma is a primary adrenal lymphoma, which accounts for 1% of all non-Hodgkin lymphomas and 3% of all extranodal lymphomas with a few cases reported in the literature. In our article, we present a case of left adrenal incidentaloma of the adrenal gland, which, during further observation and examination, increased in size, which was the reason for performing laparoscopic adrenalectomy. According to the results of the histological examination, the mass turned out to be diffuse large B-cell lymphoma.

Thymic cysts are a rare abnormality accounting for 1%–3% of all mediastinal masses. In most cases, they are asymptomatic and localized in the anterior mediastinum. Despite their benign nature, the presence of a mass is an indication for surgery to obtain a histological conclusion and reliably exclude an oncological process. Epidermoid cysts are rare and only a few cases are described in the literature. In our case report, we present a rare case of examination and treatment of a patient with a large anterior mediastinum mass, which, according to the results of histology, was an epidermoid cyst of the thymus.

Presacral teratoid cyst (PTC) is a congenital structural abnormality located in the pararectal area and containing tissues from different germ layers. Cases of diagnosis and treatment of PTC in adults are extremely rare and there is little information about the treatment tactics and prognosis. We describe a case of PTC in a 28-year-old woman, with a description of the diagnostic process, preoperative and postoperative management, as well as a brief review of the literature on this topic. A reconstructive surgery was performed on the perineum, including: parasacral access, excision of the presacral cyst together with removal of the coccyx and plastic of the opening. The postoperative observation of the patient was without complications.

Asthma is the most common chronic respiratory disease worldwide and its prevalence is increasing. Acute asthma complications are often the reason for admission to emergency healthcare service. In our article we present a case of a rare asthma complication – spontaneous pneumomediastinum with a short review of its incidence, etiology, diagnosis and management. Spontaneus pneumothorax is important to differentiate with secondary pneumomediastinum as well as other conditions as cardiac diseases (acute coronary syndrome, pericarditis, cardiac tamponade, pneumopericardium), lung diseases (pneumothorax, pulmonary embolism, tracheobronchial tree rupture), musculoskeletal disorders, and diseases of the esophagus (rupture and perforation o the esophagus). A chest X-ray is often reliable for diagnosis of spontaneous pneumomediastinum and when inconclusive, can be followed by CT. The management is usually conservative with oxygen and analgesia. Surgery is required only in cases of tracheobronchial compression.

The celiac trunk is the first major branch of the abdominal aorta. It originates from the ventral aspect of the aorta at the level of T12–L1 vertebrae and was originally described as an artery that branches into the common hepatic artery, left gastric artery, and splenic artery. Absence of the celiac trunk and origin of the three arteries separately from the aorta is a rare entity that is reported in 0.38% to 2.6% of cases. It is even more uncommon that this variation can be accompanied by other vascular variations of the upper abdomen as accessory arteries to the liver, stomach, and pancreas. These cases arise during embryogenesis due to decreased arterial degeneration combined with decreased arterial fusion, which results in the anatomical variations present in the current case. Complex arterial variations are both a risk for iatrogenic injury during surgical procedures and beneficial during endovascular supply as they may provide additional access for embolization and chemotherapy.