Primary endotracheal hamartoma is an exceedingly rare benign neoplasm. Owing to the substantial functional reserve of the trachea, most patients remain asymptomatic in early stages, and these lesions are frequently overlooked or misdiagnosed as asthma, chronic obstructive pulmonary disease, or mucus plugs. This diagnostic pitfall is particularly common in young, never-smoker patients in whom the pretest probability for primary airway neoplasms is extremely low. We report a case of endotracheal hamartoma in a 32-year-old asymptomatic never-smoker woman that was incidentally discovered during routine screening and initially misinterpreted as a mucus plug. A 32-year-old asymptomatic never-smoker woman presented with a fixed intraluminal tracheal nodule incidentally discovered on routine chest computed tomography (CT), which was initially misinterpreted as a mucus plug (retained airway secretion). Prompted by a pulmonologist’s clinical suspicion, contrast-enhanced CT, ¹⁸F-FDG PET/CT, and bronchoscopic evaluation were performed. Rigid bronchoscopy with electrocautery snare and argon plasma coagulation achieved complete bronchoscopic removal with no visible residual lesion. Histopathology confirmed cartilaginous hamartoma. The patient recovered uneventfully and remained asymptomatic at follow-up. Despite the absence of respiratory symptoms, pulmonary function testing revealed a severe obstructive ventilatory defect with reduced diffusing capacity for carbon monoxide. Bronchoscopy at postoperative week 7 confirmed complete bronchoscopic removal with no visible residual lesion, and surveillance chest CT at 11 months post-procedure showed a patent trachea and major bronchi with no evidence of recurrence. This case highlights the diagnostic challenges associated with primary endotracheal hamartoma in young, asymptomatic, low-risk patients. The initial misinterpretation of a fixed intraluminal nodule as a benign secretion underscores the necessity of bronchoscopic verification before accepting a presumptive non-neoplastic diagnosis. Early bronchoscopic evaluation enables effective endoscopic removal and prevents diagnostic delay. Notably, severe pulmonary function abnormalities preceded any respiratory symptom in this patient. This case demonstrates that maintaining clinical suspicion and pursuing early bronchoscopic evaluation are essential for the accurate diagnosis and effective endoscopic management of endotracheal hamartoma in young, asymptomatic patients. Objective pulmonary function abnormalities, such as an unexplained obstructive ventilatory defect, may precede symptoms and should prompt airway evaluation in patients with a fixed intraluminal nodule.
This study aims to investigate the efficacy and safety of CT-guided radiofrequency ablation (RFA) targeting the facial nerve via the stylomastoid foramen in treating primary hemifacial spasm (HFS), with a focus on short-term outcomes. This study retrospectively included patients diagnosed with primary HFS who underwent partial radiofrequency ablation of the facial nerve at the Pain Department of the First Hospital of Jiaxing from August 2018 to August 2023. All patients successfully underwent percutaneous puncture under CT guidance and received continuous standard radiofrequency treatment, characterized by a stepwise temperature increase from low to high. We collected basic preoperative data and conducted regular follow-ups with the patients postoperatively. The study recorded and analyzed the varying House-Brackmann (HB) grades of facial paralysis following surgery, the time to recurrence, intraoperative and postoperative complications, as well as the Self-Rating Anxiety Scale (SAS) scores and Self-Rating Depression Scale (SDS) scores of the patients before and after treatment. A total of 195 patients were included, with a median follow-up of 15 months (range: 1–58 months). Of the 195 patients, 182 (93.3
Occult appendiceal neoplasms are uncommon but clinically important findings in patients undergoing appendectomy for presumed acute appendicitis. This study aimed to determine their prevalence and evaluate preoperative factors associated with occult appendiceal neoplasia. This retrospective cohort study included consecutive patients who underwent appendectomy for presumed acute appendicitis between January 2020 and December 2025. Mucinous neoplasia, neuroendocrine tumors, adenocarcinoma, and sessile serrated lesions identified on final histopathological examination were classified as occult appendiceal neoplasms. Demographic, laboratory, and radiological variables were evaluated using univariate and multivariable logistic regression analyses. Receiver operating characteristic analysis was used to assess the discriminatory performance of age. A total of 3,573 patients were included, of whom 39 had occult appendiceal neoplasms (1.09
The sinus tarsi approach (STA) is a minimally invasive approach for intra-articular calcaneal fractures. Compared to the extended lateral approach (ELA), STA offers fewer wound complications and allows early operation. After obtaining a sound reduction of posterior facet and hindfoot alignment, the fixation strategy which varies from K-wire to plate can be used. In our study, we focused on Combo and perimeter plates. To evaluate the clinical results between these two plates, we conducted this retrospective clinical study. From January 2022 to July 2025, 38 patients with closed intra-articular calcaneal fractures who received open reduction and internal fixation (ORIF) with Combo or perimeter plate via the sinus tarsi approach were recruited. All patients underwent postoperative clinical and radiological evaluation. Patients were followed up postoperatively. The following scores and parameters were recorded (Combo group vs. perimeter group): value of VAS (0.24 ± 0.44 vs. 0.32 ± 0.48), The AOFAS Ankle-Hindfoot score (94.1 ± 4.0 vs. 92.0 ± 5.1), Böhler’s angle (31.67 ± 3.15° vs. 30.05 ± 2.09°), Gissane’s angle (116.71 ± 6.73° vs. 117.16 ± 5.57°), calcaneal length (86.24 ± 4.58 mm vs. 86.34 ± 4.02 mm), and calcaneal height (87.38 ± 4.07 mm vs. 86.86 ± 3.38 mm) showed no statistically significant difference between the two groups after 6–22 months’ follow-up. However, calcaneal width was significantly smaller in the perimeter group at the last follow-up (38.99 ± 3.33 mm vs. 36.01 ± 3.22 mm). There was no wound necrosis, infection, or malunion in these two groups. In this retrospective cohort, both Combo and perimeter plate fixation via the sinus tarsi approach appeared feasible, with acceptable radiological and clinical results at short-term follow-up. These findings should be interpreted within the limits of the small sample size and short follow-up, and do not establish clinical equivalence between the two strategies.
Vesical hernia through the inguinal canal is an uncommon variant of a sliding hernia associated with bladder outlet obstruction in older men. Vesical stones present within a herniated segment of the bladder are extremely rare and often missed clinically. A 72-year-old gentleman presented with a 10-year history of right groin mass with lower urinary tract symptoms (urgency, frequency, dysuria) with hematuria for several months. Two previous inguinal hernias repairs and open transvesical prostatectomy due to benign prostatic hyperplasia were done 18 months before. There was a history of a vesical stone found preoperatively on ultrasonography, which could not be located at the time of the operation and its extraction was stopped. Due to persisting complaints and groin pain, further investigation was carried out. Ultrasonography and CT revealed recurrent ainguinal hernia with a bladder component and a 3 × 3 cm stone in it. Due to the patient’s refusal, preoperative cystoscopy was not performed. Open exploration of the groin confirmed the presence of extraperitoneal direct inguinal hernia with bladder and the stone within. Cystolithotomy allowed to extract a stone with a size 3.2 × 3.0 cm, made mainly of calcium oxalate monohydrate. The cystotomy was closed in two layers and a hernia repair was performed using Shouldice method with additional polypropylene mesh. The postoperative course was uneventful. At one-year follow-up, the patient was symptom free with no clinical evidence of the hernia recurrence and no radiological remnants of the stone on plain abdominal radiography. Lower urinary tract symptoms in a patient with an inguinal hernia require urological evaluation. Uncertain anatomy can be clarified with cross-sectional imaging like CT regarding the position of the bladder and hernia sac. If the stone cannot be found during the operation, it needs to be investigated because of its possible presence within a herniated segment of the bladder.
