Background: During the last years, the COVID-19 pandemic meets the pandemic generated by obesity, raising many questions regarding the outcomes of those with severe forms of infection. Methods: The present systematic review summarises and analyses the data providing evidence for or against the “obesity-paradox” in COVID-19 patients. After applying the inclusion and exclusion criteria, 23 studies were included. We also analysed the presumably underlying basic mechanisms. Results: The patients with a body mass index (BMI) of 30–40 kg/m² presented severe symptoms that led to intensive care unit (ICU) admission but not increased death rate. Those with a higher degree of obesity, with a BMI higher than 40 kg/m², led to a rise in the death rate, particularly in young patients. Obesity was associated with a higher rate of ICU admission but was not determined as an independent predictor of increased mortality. In contrast, some studies suggest a strong association between obesity or morbid obesity and the risk of death. Conclusions: The existence of “obesity-paradox” cannot be stated; our study presents obesity as a critical risk factor in the evolution of COVID-19.

We report a case of a 52-year-old woman who was referred to our institution with a superior vena cava syndrome and was investigated through echocardiography, CT and MRI revealing a well-defined, encapsulated pericardial mass. The pathology, correlated with the immunohistochemical analysis, concluded it was an extremely rare primary pericardial synovial sarcoma. The patient underwent surgery and chemotherapy with a 16-month disease-free survival and passed away after a contralateral aggressive relapse. Moreover, we discuss the role of each imaging modality together with their pericardial synovial sarcoma reported features.

Background: Comprehensive molecular profiling is essential for precision oncology in non-small cell lung cancer (NSCLC). However, genomic data from Eastern European populations, including Romania, remain limited. Methods: We analyzed 398 consecutive NSCLC cases tested at the PATHOS Molecular Pathology Laboratory (Cluj-Napoca, Romania) between April 2024 and February 2025 using the Ion Torrent™ Genexus™ System and the Oncomine™ Dx Target Test, which evaluates SNVs/indels in 46 genes, fusions in 23 genes, and CNVs in 19 genes from FFPE samples. Results: The cohort was predominantly male (66%) with a median age of 67 years. Adenocarcinoma represented 70% of cases with known histology. Genomic profiling revealed a high frequency of actionable alterations. KRAS mutations were the most common (29.1%), with p.G12C detected in 10.3% of all the cases. EGFR mutations were present in 14.3% of patients, mostly exon 19 deletions and L858R substitutions. BRAF alterations (5.3%) included both V600E and non-V600E variants. RET alterations were detected as eight missense mutations, two canonical fusions (KIF5B–RET, CCDC6–RET), one amplification, and three transcript imbalances. EML4-ALK fusions (1.77%), ERBB2 mutations/amplifications (3.0%), and FGFR1/FGFR3 amplifications were also observed. Conclusions: This study provides the first large-scale molecular snapshot of NSCLC in Romania. While the overall genomic profiles align with Western populations, the higher frequency of KRAS p.G12C and FGFR amplifications highlights the value of region-specific data to support targeted therapies in Eastern Europe.

Arrhythmogenic right ventricular dysplasia (ARVD) is a rare genetic condition of the myocardium, with a significantly high risk of sudden death. Recent genetic research and improved understanding of the pathophysiology tend to change the ARVD definition towards a larger spectrum of myocardial involvement, which includes, in various proportions, both the right (RV) and left ventricle (LV), currently referred to as ACM (arrhythmogenic cardiomyopathy). Its pathological substrate is defined by the replacement of the ventricular myocardium with fibrous adipose tissue that further leads to inadequate electrical impulses and translates into varies degrees of malignant ventricular arrythmias and dyskinetic myocardium movements. Particularly, the cardio-cutaneous syndromes of Carvajal/Naxos represent rare causes of ACM that might be suspected from early childhood. The diagnostic is sometimes challenging, even with well-established rTFC or Padua criteria, especially for pediatric patients or ACM with LV involvement. Cardiac MRI gain more and more importance in ACM diagnostic especially in non-classical forms. Furthermore, MRI is useful in highlighting myocardial fibrosis, fatty replacement or wall movement with high accuracy, thus guiding not only the depiction, but also the patient’s stratification and management.

Background/Objectives: Primary hyperparathyroidism (PHPT) is a prevalent endocrine disorder, with ectopic mediastinal parathyroid adenomas accounting for up to 30% of cases, posing significant diagnostic and surgical challenges. While traditional management relies on invasive procedures, minimally invasive techniques such as video-assisted thoracoscopic surgery (VATS) have emerged as viable alternatives. This study addresses a gap in the current literature by presenting our experience with VATS for mediastinal ectopic parathyroid adenomas, particularly in underreported retrotracheal/paraesophageal locations. By integrating a retrospective case series with a systematic literature review, we highlight evolving surgical strategies and their implications for patient outcomes in anatomically complex cases. Methods: A retrospective analysis was conducted over a three-year period on patients diagnosed with mediastinal ectopic parathyroid adenomas. Data on demographic characteristics, preoperative imaging, surgical techniques, intraoperative findings, and postoperative outcomes were collected. This study primarily compared the outcomes of VATS with those of traditional thoracotomy, with a focus on surgical success, complication rates, and length of hospital stay. Results: Six patients underwent surgical resection for mediastinal ectopic parathyroid adenomas (two intrahymic and four retrotracheal/paraesophgeal). VATS was the preferred approach in all cases, with one patient requiring conversion to thoracotomy due to challenging vascular anatomy. Surgical success, defined as the normalization of postoperative serum calcium levels, was achieved in all cases. The median operative time was 80 min, and the mean hospital stay was 6.25 days. One patient developed transient postoperative hypocalcemia, necessitating supplementation. No major surgical complications were observed. Conclusions: This study supports VATS as a safe and effective approach for mediastinal ectopic parathyroid adenoma resection, offering reduced morbidity and shorter recovery times compared to traditional open surgery. The findings align with emerging evidence advocating for minimally invasive techniques in complex mediastinal surgeries.

Background/Objectives: Primary chest wall tumors or malignancies of adjacent organs with chest wall infiltration present a significant challenge for surgical resection and reconstruction. Larger defects involving the sternum, resections in the area of the thoracic apertures, or those near the spine are difficult to reconstruct. The reconstruction has to ensure stability, to prevent paradoxical movements and lung herniation, while also achieving a satisfactory cosmetic result. The “spider web” technique restores chest wall stability by creating a web-like framework made of non-resorbable threads fixed to adjacent bony structures. Additionally, a synthetic mesh is placed over the web construct, and both layers are covered with muscles (local muscles or different types of flaps). In this prospective study, clinical data from patients who underwent surgery using the “spider web” technique were analyzed with respect to chest wall stability, procedure-specific complications, pulmonary function, and patient satisfaction. Methods: A total of 16 patients receiving 18 chest wall resections and reconstructions using the “spider web” technique were followed for at least one year. Chest wall stability and lung function (FEV1 and DLCO) were assessed. Quality of life, cosmetic satisfaction, potential functional impairment, and analgesic consumption were measured using a modified EORTC QLQ-C30 questionnaire. Results: The follow-up period ranged from 12 to 32 months. In all cases, optimal chest wall stability was maintained without impairment of respiratory mechanics. Procedure-specific complications occurred in five cases (27.8%), including seroma (one case), hematoma (two cases), necrosis at the TRAM flap donor site (one case), and mesh infection (one case), all of which were resolved without further complications. Postoperative FEV1 and DLCO were not significantly reduced compared with preoperative values. The global health status score for quality of life was 60 ± 27 points. Nine patients reported being able to ascend at least one floor of stairs without shortness of breath and half of the patients were able to participate in sports activities. One patient required prolonged analgesic medication due to chronic pain. In all cases, patients were satisfied with the cosmetic result. Both 30-day and 90-day mortality were 0%. No local recurrence at the chest wall reconstruction site occurred. Conclusions: The “spider web” technique is a highly suitable method for chest wall reconstruction, allowing covering all types of chest wall defects, regardless of size and location. This cost-effective technique not only provides optimal stability but also good functional results.