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During the physical exam, she was found to have a large fungating mass in the right groin. Upon further questioning, she reported that the mass began as a small swelling in the groin three months ago and was evaluated by the primary care physician and received antibiotics for two weeks. During this time, she did not have any worsening pulmonary symptoms. She underwent bedside excisional biopsy of the lymph node; the pathology came back positive for metastatic adenocarcinoma of pulmonary origin. Unfortunately, the patient had a significant worsening of her respiratory distress; she transitioned to comfort measures and passed away three days later. EG-011 In this article, we report a case of metastatic lung adenocarcinoma with the inguinal lymph nodes' involvement as the site of distant metastasis, followed by a brief review of the occurrence of adenocarcinoma with the inguinal lymph nodes' involvement.Current mass casualty incident (MCI) response in the United States calls for rapid deployment of first responders, such as law enforcement, fire, and emergency medical services personnel, to the incident and simultaneous activation of trauma center disaster protocols. Past investigations demonstrated that the incorporation of advanced trauma-trained physicians and paramedics into prehospital teams resulted in improved mortality during routine emergency medical care in Europe and in the combat setting. To date, limited research exists on the incorporation of advanced trauma-trained physicians and paramedics into prehospital teams for civilian MCIs. We proposed the concept of Special Medical Response Teams, which would rapidly deploy advanced trauma-trained physicians and paramedics to deliver a higher level of medical and surgical care in the prehospital setting during civilian mass casualty incidents.Brucellosis is infrequently reported in the United States and is mostly an occupational hazard among workers engaged in livestock raising and processing. It is a systemic infectious disease and can involve the liver in varying ways, ranging from benign subclinical increases in serum aminotransferase levels to ominous chronic suppurative disease. It is endemic in many countries, primarily those of the Mediterranean region. It is usually treated with antibiotics. We present a case of a 37-year-old female who developed Brucella melitensis-induced transaminitis, which improved with proper diagnosis and management.While elbow dislocation is a common occurrence, the vast majority of them dislocate posteriorly and are due to disruption of the elbow stabilizers, which start on the lateral side and proceed medially, disrupting the anterior and posterior stabilizing structures. We present an unusual case of anterior elbow dislocation, with disruption of the medial stabilizing structures and anterior capsule, without any bony injury. A 44-year-old man presented to the ED after being assaulted. While the exact mechanism of injury was unclear, the patient believes he had been struck with a heavy object on the posterior aspect of his elbow. His dislocation was reduced in the ED, but was highly unstable after reduction. Further imaging revealed disruption of his medial collateral ligaments and common flexor origin. He went on to have an open repair of his medial structures with suture anchors. After six weeks of follow-up he was doing well, with no further episodes of instability and a good functional range of movement. Though rare, anterior elbow dislocations have been reported sporadically in the literature. Surgeons and ED doctors dealing with these injuries should be aware that the maneuvers to relocate the elbow will be different compared to the standard maneuvers used for posterior dislocations. Patients should be examined for stability after reduction, especially on valgus stressing. We would advocate for low threshold for performing an examination under anesthesia (EUA), with open repair of the stabilizing structures if persistently unstable after reduction.Killian-Jamieson diverticula (KJD) and Zenker's diverticula (more common) share similar pathophysiology but are considered to be different types of phrenoesophageal diverticula. A 55-year-old female presented to the clinic with chronic dysphagia, halitosis, and regurgitation. Imaging modalities confirmed a Killian-Jamieson diverticulum, explaining her symptoms. She was offered different treatment options and decided to proceed with a less invasive endoscopic approach. Physicians should be aware of the variable presentations of KJD and the different available treatments as newer techniques are becoming more popular and preferable by patients.We present the case of a 96-year-old female, with no known cardiac history, who suffered a myocardial infarction (MI) one hour after her first Moderna coronavirus disease 2019 (COVID-19) vaccination. The patient was medically managed and discharged three days later. We are unable to attribute the cause of the patient's MI to the Moderna vaccine unless further data are published. As healthcare providers, we need to be aware of attempts to correlate bad outcomes with the vaccine without substantiated data, and anticipate patient questions that may arise from these reports. Any research on the topic should be written carefully and avoid overstating the findings. If more reports of serious side effects in older adults are published, providers should consider additional screenings prior to COVID-19 vaccination.Introduction Invasive ductal carcinoma (IDC) is the most common histological subtype of breast cancer. Conversely, many special types of breast carcinoma were described with varying prognosis and hormone receptor status. Mucinous carcinoma (MC) is a rare special subtype of breast cancer, and only a few studies have evaluated the clinicopathological and hormone receptor profile of this type of breast cancer. Therefore, in this study, we compared the clinicopathological characteristics of MC with IDC in our population. Methods A retrospective observational study was conducted in the Department of Histopathology, Liaquat National Hospital and Medical College, from January 2013 till December 2020, for eight years. During this period, 38 cases of MC were diagnosed and 1268 cases of IDC were identified. All specimens were grossed according to standard protocols and representative sections were submitted from tumors, resection margins, and lymph nodes. Slides were examined by histopathologists to determine tumor type and grade.
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