The patient, at 10 weeks gestation, was admitted for severe dehydration due to hyperemesis gravidarum. The  patient had glaucoma, and treatment with eye drops was continued during the patient’s stay. She responded well to  IV fluid hydration and antiemetics.
PREOPERATIVE DIAGNOSIS:1. Left chest wall mass.2. Ovarian cancer.
POSTOPERATIVE DIAGNOSIS:1. Left chest wall mass.2. Ovarian cancer.
PROCEDURE PERFORMED:1. Bronchoscopy with evaluation of bronchial tree tube.2. Left video-assisted thoracoscopy.3. Resection of anterior chest wall mass with resection of pleura.
PROCEDURE: After proper consent was obtained the patient taken to and placed on operating room table in supine position. General sedation was administered by oral endotracheal tube. The bronchoscope was inserted. Right upper lobe, middle lobe and lower lobe were normal. No endobronchial lesions seen. Scope was inserted in left upper lingula lobe segments were normal. The patient was placed in a right lateral decubitus position. Left chest prepped and draped in normal sterile fashion. Incision made and the thoracoscope inserted. Under direct vision additional lateral port placed. Dissection was then carried down. The mass identified within chest wall. It was confined to the pleura. This appeared to be a large plaque, approximately 10 x 4 cm. Separate satellite mass was present. Using the Bovie electrocautery, the pleura was then dissected from the chest wall. The entire chest wall mass was resected including the pleural lesion. It was then placed in EndoCatch, removed and sent to Pathology for analysis. No other areas were seen on the pleura. Meticulous hemostasis obtained. Chest tube placed to the apex and anchored with heavy silk. Lung re-expanded no significant air leak. Wound then closed in layers with absorbable suture. Chest tube anchored with heavy silk.Dermabond sterile bandage placed on the wound.
The patient tolerated procedure well, in stable condition.