PMC5723367_01
CT of the chest shows 1.5 cm mass in the right middle lobe (red arrows).
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blood culture were sterile, reassessment of the ectopic spot through MSCT for the neck,chest and abdomen was done and this time showed a 2 cm mass in the right middle lobe (Fig. 1) and the adrenals reappeared in both sides (Fig. 2).
Intraoperative pictures of the resected nodule: A: demonstrates dissection of the nodule from adjacent structures, B: The resection is complete with adequate surgical margin.
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After a week on empiric antibiotic the patient's lab results returned to normal, the patient was prepared with 100 mg hydrocortisone before surgery to match the increased need for cortisol in stressful situations such as surgical operation, a right thoracotomy on the fifth intercostal space was made, 2 cm mass in the right middle lobe was found and a wedge shaped resection of the mass was done (Figs. 3 ) and a sample from mediastinal lymph nodes was taken followed by proper closure and a chest tube in place.