Presented is a case of a chest wall metastasis due to tumor seeding along the needle tract from a percutaneous fine-needle aspiration biopsy (FNAB) of a lung carcinoma. At thoracostomy, the patient was found to have a chest wall lesion at the site of the FNAB that had been performed 4 months earlier. This relatively uncommon complication has been reported elsewhere, but its significance with respect to the management of lung lesions suspected to be malignant has not been defined. The authors maintain that FNAB may not be indicated in select patients. The application of this diagnostic modality should be considered individually on the basis of the patient's operative risk as well as the risk for having a primary lung carcinoma develop.

Aged↗

PubMed1994

Management of anomalous rotation in adults.

Rotational anomalies of the gut are infrequently encountered in the adult population. Management of this population is debatable because of a few anecdotal reports and small patient series. We present the successful surgical correction of a patient with symptomatic nonrotation and review our experience with six asymptomatic patients with anomalous rotation discovered incidentally at laparotomy for another disease process. The incidence of anomalous rotation is reported as high as 0.5% in autopsy series. Therefore, a large majority of subjects are clinically silent throughout life. Although a surgical emergency in the pediatric population, serendipituous discovery in the asymptomatic adult does not require surgical intervention. It is important, however, that the patient have a thorough understanding of his abnormality so that should symptoms arise, urgent surgical intervention may be warranted. We recommend appendectomy in those patients undergoing laparotomy for other conditions. In patients with chronic abdominal symptoms, surgical intervention is warranted.

Adult↗